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General NPI Number Information
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NPI Number | 1134109432
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Entity Type | Individual
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Provider Name | CATHLEEN YVONNE CHIDESTER PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 2112 W DAVIS ST
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City | CONROE
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State | TX
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Zip | 77304-2049
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Country | US
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Telephone | 713-960-1311
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Fax | 713-960-1325
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Provider Business Mailing Address
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Address Line | 4707 EIGEL ST STE 100
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City | HOUSTON
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State | TX
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Zip | 77007-3417
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Country | US
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Telephone | 713-960-1311
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Fax | 713-960-1325
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA05324
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License Number State | TX
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