Provider Demographics
NPI:1205084688
Name:IKBAL, KATRINY A (DO)
Entity type:Individual
Prefix:DR
First Name:KATRINY
Middle Name:A
Last Name:IKBAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 BEE CAVE RD
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738
Mailing Address - Country:US
Mailing Address - Phone:512-842-7633
Mailing Address - Fax:512-368-8234
Practice Address - Street 1:12005 BEE CAVE RD
Practice Address - Street 2:SUITE A-1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738
Practice Address - Country:US
Practice Address - Phone:512-842-7633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNOT IN NETWORK WITH ANY INSURANCE CARRIER