Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L0414 | TX |
N | 111NI0900X | Internist | L0414 | TX |
N | 207RA0401X | Internist - Addiction Medicine | L0414 | TX |
NPI | 1609965078 |
---|---|
Provider Name | Katherine Mcqueen |
First Address | Bellaire, TX 77401-3500 |
Second Address | Bellaire, TX 77401-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H22466 | (02) |