Healthcare Provider Details

I. General information

NPI: 1548796345
Provider Name (Legal Business Name): KATHLEEN TENNYS BIEDERMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5252 HOLLISTER ST SUITE #201
HOUSTON TX
77040-6214
US

IV. Provider business mailing address

4613 BEE CAVES RD STE 105
WEST LAKE HILLS TX
78746-5206
US

V. Phone/Fax

Practice location:
  • Phone: 346-410-0404
  • Fax:
Mailing address:
  • Phone: 512-892-0490
  • Fax: 512-892-0589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP133863
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: