Provider Demographics
NPI:1801034228
Name:DALE, CATHIE ANN (BSN, RN, CN)
Entity Type:Individual
Prefix:MRS
First Name:CATHIE
Middle Name:ANN
Last Name:DALE
Suffix:
Gender:F
Credentials:BSN, RN, CN
Other - Prefix:
Other - First Name:CATHIE
Other - Middle Name:ANN
Other - Last Name:WATHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:5629 FM 1960 WEST
Mailing Address - Street 2:SUITE 231
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4215
Mailing Address - Country:US
Mailing Address - Phone:281-440-5553
Mailing Address - Fax:281-440-5559
Practice Address - Street 1:5629 FM 1960 WEST
Practice Address - Street 2:SUITE 231
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4215
Practice Address - Country:US
Practice Address - Phone:281-440-5553
Practice Address - Fax:281-440-5559
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX560208163WP0808X
133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No133N00000XDietary & Nutritional Service ProvidersNutritionist