Healthcare Provider Details

I. General information

NPI: 1235107392
Provider Name (Legal Business Name): CATHY L. LITTLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CEDAR BEND DR.
AUSTIN TX
78758-2483
US

IV. Provider business mailing address

12221 MOPAC EXPRESSWAY NORTH
AUSTIN TX
78758-2483
US

V. Phone/Fax

Practice location:
  • Phone: 512-901-4016
  • Fax: 512-901-3857
Mailing address:
  • Phone: 512-901-4016
  • Fax: 512-901-3857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG8543
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: