Provider Demographics
NPI:1801232327
Name:CHING, KATHRYN WATSON (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:WATSON
Last Name:CHING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12600 HILL COUNTRY BLVD
Mailing Address - Street 2:STE R-130 PMB 1018
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6723
Mailing Address - Country:US
Mailing Address - Phone:512-470-8811
Mailing Address - Fax:
Practice Address - Street 1:2727 EXPOSITION BLVD STE 105
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1227
Practice Address - Country:US
Practice Address - Phone:512-470-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ43312083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program