Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | PA13213 | TX |
NPI | 1265077697 |
---|---|
Provider Name | Katherine Suzanne Buckner |
First Address | Houston, TX 77007-1479 |
Second Address | Houston, TX 77030-4509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2019 |
Last Update Date | 08/11/2019 |