Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | R6441 | TX |
NPI | 1316212590 |
---|---|
Provider Name | Katherine Clare Michelis |
First Address | Dallas, TX 75284-7208 |
Second Address | Dallas, TX 75390-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 16/08/2021 |