Healthcare Provider Details

I. General information

NPI: 1891162020
Provider Name (Legal Business Name): KRISTIN MARIE KUTAC P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. KRISTIN MARIE JUNG

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S US HIGHWAY 281
MARBLE FALLS TX
78654-9703
US

IV. Provider business mailing address

800 S US HIGHWAY 281
MARBLE FALLS TX
78654-9703
US

V. Phone/Fax

Practice location:
  • Phone: 830-693-4800
  • Fax: 830-310-6380
Mailing address:
  • Phone: 830-693-4800
  • Fax: 830-310-6380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA09975
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA09975
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: