Provider Demographics
NPI:1184941262
Name:KUEHN, MARILYN KATHERINE
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:KATHERINE
Last Name:KUEHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 542333
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254
Mailing Address - Country:US
Mailing Address - Phone:713-299-7677
Mailing Address - Fax:281-768-6766
Practice Address - Street 1:804 CIRCLE DR.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-299-7677
Practice Address - Fax:281-768-6766
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
TXCERT.#112610363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical