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General NPI Number Information
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NPI Number | 1235288259
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Entity Type | Individual
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Provider Name | KATRINA L MCFADDEN DDS
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 5600 N GATE RD STE 103
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City | GRANBURY
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State | TX
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Zip | 76049-3119
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Country | US
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Telephone | 817-326-5717
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Fax | 817-326-5714
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Provider Business Mailing Address
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Address Line | 5600 NORTHGATE ROAD STE 103
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City | GRANBURY
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State | TX
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Zip | 76049
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Country | US
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Telephone | 817-326-5717
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Fax | 817-326-5714
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19566
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License Number State | TX
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