Provider Demographics
NPI:1336456045
Name:MAU, KATHERINE O (LVN)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:O
Last Name:MAU
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 DALLAS ST # 200A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1201
Mailing Address - Country:US
Mailing Address - Phone:210-225-6508
Mailing Address - Fax:210-225-1486
Practice Address - Street 1:6800 PARK TEN BLVD STE 154-E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4243
Practice Address - Country:US
Practice Address - Phone:210-828-2503
Practice Address - Fax:210-828-0590
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134035164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse