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1679849178

NPI Code Detail

MEDICARE: KATHERINE BOHARD SALCICCIOLI MD

MEDICARE: KATHERINE BOHARD SALCICCIOLI MD

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
1	207R00000X	Internal Medicine Physician	BP10042711	TX
2	207R00000X	Internal Medicine Physician	4301117203	MI
3	208000000X	Pediatrics Physician	BP10042711	TX
4	2080P0202X	Pediatric Cardiology Physician	Q6369	TX

General Provider Information

NPI Number	:	1679849178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE BOHARD SALCICCIOLI MD

Provider Business Mailing Address
First Line	:	6651 MAIN ST STE E1920
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2428
Country	:	US
Telephone Number	:	832-822-2243
Fax Number	:	832-826-4286

Provider Business Practice Location Address
First Line	:	6651 MAIN ST STE E1920
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2428
Country	:	US
Telephone Number	:	328-222-2438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	05/15/2025

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Directions to “ KATHERINE BOHARD SALCICCIOLI MD” Practice Location

Language	Start Address	Practice Location

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