Provider Demographics
NPI:1790447621
Name:DILIBERTO, KATHERINE SOPHIE (NP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SOPHIE
Last Name:DILIBERTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 BRANFORD PL STE 240
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3794
Mailing Address - Country:US
Mailing Address - Phone:281-240-4313
Mailing Address - Fax:
Practice Address - Street 1:4500 WASHINGTON AVE STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5477
Practice Address - Country:US
Practice Address - Phone:281-857-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily