Healthcare Provider Details

I. General information

NPI: 1336453190
Provider Name (Legal Business Name): KATHRYN LORRAINE DUPLANTIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2010
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 HILLCREST PLAZA DR SUITE 223
DALLAS TX
75230-1400
US

IV. Provider business mailing address

6750 HILLCREST PLAZA DR SUITE 223
DALLAS TX
75230-1400
US

V. Phone/Fax

Practice location:
  • Phone: 972-934-9808
  • Fax: 972-934-9806
Mailing address:
  • Phone: 972-934-9808
  • Fax: 972-934-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberJ3784
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: