Provider Demographics
NPI:1982610796
Name:KATHLEEN A BRACE GAUL
Entity Type:Organization
Organization Name:KATHLEEN A BRACE GAUL
Other - Org Name:HARLINGEN PODIATRY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRACE GAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:956-428-2442
Mailing Address - Street 1:1911 LUBBOCK ST STE B
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8235
Mailing Address - Country:US
Mailing Address - Phone:956-428-2442
Mailing Address - Fax:956-428-3132
Practice Address - Street 1:1911 LUBBOCK ST STE B
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8235
Practice Address - Country:US
Practice Address - Phone:956-428-2442
Practice Address - Fax:956-428-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0667213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00B86GMedicare PIN
TXT12388Medicare UPIN
TX0535540001Medicare NSC
TXT13414Medicare UPIN