Provider Demographics
NPI:1760599377
Name:BORTHS, KATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BORTHS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BECKMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:13300 HARGRAVE RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4373
Mailing Address - Country:US
Mailing Address - Phone:281-737-4861
Mailing Address - Fax:281-955-5108
Practice Address - Street 1:13300 HARGRAVE RD
Practice Address - Street 2:SUITE 450
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4373
Practice Address - Country:US
Practice Address - Phone:281-737-4861
Practice Address - Fax:281-955-5108
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04358363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8315NVOtherBCBS
TX8FU755OtherBCBS
TXP00391304OtherRR MEDICARE
TX180726501Medicaid
TX180726503Medicaid
TX8N8700OtherBLUE CROSS BLUE SHIELD
TX180726502Medicaid
TX180726502Medicaid
TXQ51111Medicare UPIN
TX543734ZSWDMedicare PIN
TX8FU755OtherBCBS
TX543734ZSVEMedicare PIN
TX483574YMVQMedicare PIN