Provider Demographics
NPI:1720125958
Name:BATEMAN, CATHLEEN P (MD)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:P
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W BELT LINE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2090
Mailing Address - Country:US
Mailing Address - Phone:972-293-3720
Mailing Address - Fax:
Practice Address - Street 1:130 W BELT LINE RD STE 2
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2090
Practice Address - Country:US
Practice Address - Phone:972-293-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1367207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0015EPOtherBLUECROSS BLUESHIELD
TXB21119Medicare UPIN
TX00479LMedicare ID - Type Unspecified