Healthcare Provider Details
I. General information
NPI: 1912283870
Provider Name (Legal Business Name): KATHERINE BELL LOVERIN P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/24/2011
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7401 S. MAIN
HOUSTON TX
77030
US
IV. Provider business mailing address
4046 TARTAN LN
HOUSTON TX
77025-2919
US
V. Phone/Fax
- Phone: 713-799-2300
- Fax: 713-794-3395
- Phone: 713-799-2300
- Fax: 713-794-3395
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 2023 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA07249 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 2023 |
| License Number State | OK |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PA07249 |
| License Number State | TX |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 2023 |
| License Number State | OK |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | PA07249 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: