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General NPI Number Information
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NPI Number | 1760599377
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Entity Type | Individual
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Provider Name | KATHERINE BORTHS PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 17183 INTERSTATE 45 S STE 330
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City | SHENANDOAH
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State | TX
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Zip | 77385-3313
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Country | US
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Telephone | 936-270-3655
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Fax | 936-270-3656
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Provider Business Mailing Address
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Address Line | 17183 INTERSTATE 45 S STE 330
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City | SHENANDOAH
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State | TX
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Zip | 77385-3313
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Country | US
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Telephone | 936-270-3655
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Fax | 936-270-3656
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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 | PA04358
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License Number State | TX
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