Provider Demographics
NPI:1649871526
Name:HUEBNER, KATHY LEE
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LEE
Last Name:HUEBNER
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 1:1111 HIGHWAY 6 STE 10
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4917
Mailing Address - Country:US
Mailing Address - Phone:832-532-7100
Mailing Address - Fax:
Practice Address - Street 1:1111 HIGHWAY 6 STE 10
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4917
Practice Address - Country:US
Practice Address - Phone:832-532-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX537496163W00000X
TX1030956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse