Provider Demographics
NPI:1740526235
Name:MAHON, KATHRYN (CSCM)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:MAHON
Suffix:
Gender:F
Credentials:CSCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 PRESTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8853
Mailing Address - Country:US
Mailing Address - Phone:214-505-8404
Mailing Address - Fax:
Practice Address - Street 1:3004 PRESTONWOOD DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8853
Practice Address - Country:US
Practice Address - Phone:214-505-8404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider