Provider Demographics
NPI:1356781454
Name:WALKER, KATHRYN ELENA (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELENA
Last Name:WALKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MONTCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4651
Mailing Address - Country:US
Mailing Address - Phone:720-442-3101
Mailing Address - Fax:
Practice Address - Street 1:999 E BASSE RD STE 116
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1803
Practice Address - Country:US
Practice Address - Phone:720-442-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist