Provider Demographics
NPI:1710289491
Name:DICKEY, KATERINA SHEFFIELD (DC, RPH)
Entity Type:Individual
Prefix:DR
First Name:KATERINA
Middle Name:SHEFFIELD
Last Name:DICKEY
Suffix:
Gender:F
Credentials:DC, RPH
Other - Prefix:DR
Other - First Name:KATERINA
Other - Middle Name:
Other - Last Name:SHEFFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC RPH
Mailing Address - Street 1:17209 WHIPPOORWILL TRAIL
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645
Mailing Address - Country:US
Mailing Address - Phone:512-619-1335
Mailing Address - Fax:
Practice Address - Street 1:300 BEARDSLEY LN
Practice Address - Street 2:BLDG C101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4945
Practice Address - Country:US
Practice Address - Phone:512-306-1625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11499111N00000X, 111NI0013X, 111NN1001X
TX31979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NN1001XChiropractic ProvidersChiropractorNutrition
No183500000XPharmacy Service ProvidersPharmacist