Provider Demographics
NPI:1679849178
Name:SALCICCIOLI, KATHERINE BOHARD (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BOHARD
Last Name:SALCICCIOLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANNE
Other - Last Name:BOHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6651 MAIN ST STE E1920
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2428
Mailing Address - Country:US
Mailing Address - Phone:832-822-2243
Mailing Address - Fax:832-826-4286
Practice Address - Street 1:6651 MAIN ST STE E1920
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2428
Practice Address - Country:US
Practice Address - Phone:328-222-2438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10042711207R00000X, 208000000X
MI4301117203207R00000X
TXQ63692080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics