Kennedy, Catherine Karen

Kennedy, Catherine Karen is an individual health care provider with primary practice located at 11645 Angus Rd Bldg A Ste 5 , Austin TX 78759-4100. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kennedy, Catherine Karen can be contacted via phone (512) 345-5641.

Contact Information

Primary practice address
11645 Angus Rd Bldg A Ste 5 Austin TX 78759-4100
Phone: (512) 345-5641
Fax: (512) 345-0863
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3809TG Texas

Profile Details

NPI number 1154396307
LBN Legal business name Kennedy, Catherine Karen
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Mar 1st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154396307 NPPES
Texas MEDICAID 0148105-01

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