Healthcare Provider Details

I. General information

NPI: 1568181782
Provider Name (Legal Business Name): KATHERINE MCGEORGE COLE PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8611 N MOPAC EXPY
AUSTIN TX
78759-8319
US

IV. Provider business mailing address

2450 HOLCOMBE BLVD STE NB-34L
HOUSTON TX
77021-2039
US

V. Phone/Fax

Practice location:
  • Phone: 737-220-8200
  • Fax: 737-220-8180
Mailing address:
  • Phone: 832-828-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1007004
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1007004
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: