Provider Demographics
NPI:1649708801
Name:PRINCIPE, KATHRYN RENEE (DO)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RENEE
Last Name:PRINCIPE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:RENEE
Other - Last Name:RAWLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1441 N BECKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203
Mailing Address - Country:US
Mailing Address - Phone:713-724-7841
Mailing Address - Fax:
Practice Address - Street 1:515 W MAYFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-4596
Practice Address - Country:US
Practice Address - Phone:817-468-4689
Practice Address - Fax:817-465-7872
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10060003207V00000X
TXT1526207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP10060003OtherPHYSICIAN IN TRAINING