Healthcare Provider Details

I. General information

NPI: 1972012474
Provider Name (Legal Business Name): KAITLYN CULP PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2017
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 UNIVERSITY BLVD 6.146 JOHN SEALY ANNEX
GALVESTON TX
77555-0527
US

IV. Provider business mailing address

7042 N HOLIDAY DR
GALVESTON TX
77550-3028
US

V. Phone/Fax

Practice location:
  • Phone: 409-772-1285
  • Fax:
Mailing address:
  • Phone: 714-702-0872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: