Provider Demographics
NPI:1972009389
Name:DUPONT, KATHRYN MACKENZIE (MD MPH)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MACKENZIE
Last Name:DUPONT
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MACKENZIE
Other - Last Name:DUPONT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD MPH
Mailing Address - Street 1:6621 FANNIN ST STE A210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST STE A210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2399
Practice Address - Country:US
Practice Address - Phone:832-824-5497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8200208000000X, 2080P0204X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program