Provider Demographics
NPI:1730461229
Name:CARNEY, KATHERINE TAYLOR (RPH)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:TAYLOR
Last Name:CARNEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 N FRAZIER ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1220
Mailing Address - Country:US
Mailing Address - Phone:936-756-1435
Mailing Address - Fax:
Practice Address - Street 1:2108 N FRAZIER ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1220
Practice Address - Country:US
Practice Address - Phone:936-756-1435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38624183500000X
IL051.031816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist