Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1307786 | TX |
NPI | 1104317924 |
---|---|
Provider Name | Katherine Ann Hosea |
First Address | Dallas, TX 75230-1525 |
Second Address | Dallas, TX 75230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2018 |
Last Update Date | 09/08/2018 |