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General NPI Number Information
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NPI Number | 1528647773
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Entity Type | Individual
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Provider Name | KATELYN ELIZABETH OMACHI MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 9805 BRODIE LN
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City | AUSTIN
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State | TX
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Zip | 78748-5610
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Country | US
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Telephone | 512-462-1936
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Fax |
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Provider Business Mailing Address
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Address Line | 6138 N OZARK AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3837
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Country | US
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Telephone | 773-480-9882
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | V8714
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License Number State | TX
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