Healthcare Provider Details

I. General information

NPI: 1093155046
Provider Name (Legal Business Name): KATHLEEN BLAINE SEKPE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10840 TEXAS HEALTH TRL STE 110
FORT WORTH TX
76244-6847
US

IV. Provider business mailing address

7710 MERCY RD STE 1000
OMAHA NE
68124-2372
US

V. Phone/Fax

Practice location:
  • Phone: 682-212-6437
  • Fax: 682-212-9438
Mailing address:
  • Phone: 402-717-3010
  • Fax: 402-391-0298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number7070
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number30070
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberV1257
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: