Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | N6170 | TX |
NPI | 1124174719 |
---|---|
Provider Name | Dr. Katherine Marie Brandt |
First Address | San Antonio, TX 78229-3561 |
Second Address | San Antonio, TX 78229-3561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2134926-01 | (05) | TX |