Provider Demographics
NPI:1679183131
Name:BENNETT, KATHERINE HANNAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:HANNAH
Last Name:BENNETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12208 TYSON CV UNIT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5304
Mailing Address - Country:US
Mailing Address - Phone:210-364-8272
Mailing Address - Fax:
Practice Address - Street 1:1801 E 51ST ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3434
Practice Address - Country:US
Practice Address - Phone:512-474-2662
Practice Address - Fax:866-532-6625
Is Sole Proprietor?:No
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist