Provider Demographics
NPI:1689783573
Name:BUTLER, KAREN (PA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 PINEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-5231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 FROSTWOOD DR
Practice Address - Street 2:SUITE 353
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2301
Practice Address - Country:US
Practice Address - Phone:713-465-0696
Practice Address - Fax:713-465-7334
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04081363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical