Provider Demographics
NPI:1740891225
Name:BOREN, KATY LAYNE (MPAS, PA-C)
Entity type:Individual
Prefix:MISS
First Name:KATY
Middle Name:LAYNE
Last Name:BOREN
Suffix:
Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:2120 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2418
Mailing Address - Country:US
Mailing Address - Phone:713-864-2659
Mailing Address - Fax:
Practice Address - Street 1:6807 EMMETT F LOWRY EXPY STE 303
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2548
Practice Address - Country:US
Practice Address - Phone:832-706-3326
Practice Address - Fax:832-706-3327
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA15024363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant