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NPI Code Detail

MEDICARE: DR. KATHRYN AUDRA GREENWAY MD

MEDICARE: DR. KATHRYN AUDRA GREENWAY MD
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
12085R0202XDiagnostic Radiology PhysicianM4795TX
2390200000XStudent in an Organized Health Care Education/Training ProgramBP50020819TX
32085R0204XVascular & Interventional Radiology PhysicianM4795TX

General Provider Information

NPI Number : 1649221235
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHRYN AUDRA GREENWAY MD
Provider Business Mailing Address
First Line : 1820 PRESTON PARK BLVD STE 2400
Second Line :
City : PLANO
State : TX
Zip : 75093-3716
Country : US
Telephone Number : 972-867-7862
Fax Number : 972-612-1623
Provider Business Practice Location Address
First Line : 1820 PRESTON PARK BLVD STE 2400
Second Line :
City : PLANO
State : TX
Zip : 75093-3716
Country : US
Telephone Number : 972-867-7862
Fax Number : 972-612-1623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 06/23/2022

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