MEDICARE: KD WELLNESS AND HORMONE CLINIC PLLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1558228304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KD WELLNESS AND HORMONE CLINIC PLLC

Provider Business Mailing Address
First Line	:	905 PINE VALLEY DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-7489
Country	:	US
Telephone Number	:	936-465-0558
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 PINE VALLEY DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-7489
Country	:	US
Telephone Number	:	936-465-0558
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE BLYTHE DIGGS
Credential	:	APRN-C
Telephone Number	:	936-465-0558

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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