Provider Demographics
NPI:1932105491
Name:RAPPORT, KATHY ANN (R-EEG TECH)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:RAPPORT
Suffix:
Gender:F
Credentials:R-EEG TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 EARHART DR
Mailing Address - Street 2:STE 206
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4919
Mailing Address - Country:US
Mailing Address - Phone:972-991-9950
Mailing Address - Fax:972-991-9548
Practice Address - Street 1:4100 W 15TH ST
Practice Address - Street 2:STE 208
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5801
Practice Address - Country:US
Practice Address - Phone:972-985-0498
Practice Address - Fax:972-599-1838
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2253246ZE0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2253OtherR-EEG-T
TX278OtherCNIH