Provider Demographics
NPI:1881613578
Name:KRIGER, KATHERINE KAY (PA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:KAY
Last Name:KRIGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S TEXAS AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-5361
Mailing Address - Country:US
Mailing Address - Phone:979-774-2053
Mailing Address - Fax:979-776-5914
Practice Address - Street 1:1530 TEXAS AVE S STE 100
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-3329
Practice Address - Country:US
Practice Address - Phone:979-690-4878
Practice Address - Fax:979-690-4879
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00146363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical