MEDICARE: KATHERINE ELIZABETH JIMENEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1487548236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ELIZABETH JIMENEZ

Provider Business Mailing Address
First Line	:	3401 W PARMER LN APT 2438
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4143
Country	:	US
Telephone Number	:	956-441-9751
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 W PARMER LN APT 2438
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4143
Country	:	US
Telephone Number	:	956-441-9751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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