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NPI Code Detail

MEDICARE: MARY KATHRYN KILGO

MEDICARE: MARY KATHRYN KILGO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist511545TX

General Provider Information

NPI Number : 1417783861
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KATHRYN KILGO
Provider Business Mailing Address
First Line : 14818 VINTAGE PRESERVE PKWY APT 2109
Second Line :
City : HOUSTON
State : TX
Zip : 77070-3176
Country : US
Telephone Number : 806-470-8798
Fax Number :
Provider Business Practice Location Address
First Line : 7915 FM 1960 RD W STE 300
Second Line :
City : HOUSTON
State : TX
Zip : 77070-2285
Country : US
Telephone Number : 713-352-8090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2024
Last Update Date : 09/11/2024

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Directions to “ MARY KATHRYN KILGO ” Practice Location

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