1457328361 NPI number — DR. KATHARINE WOLCOTT MARKELL M.D.

Table of content: MRS. BARBARA ANN SALAZAR-NADEAU CNMT (NPI 1962743302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457328361 NPI number — DR. KATHARINE WOLCOTT MARKELL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARKELL
Provider First Name:
KATHARINE
Provider Middle Name:
WOLCOTT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WOLCOTT
Provider Other First Name:
KATHARINE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457328361
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3551 ROGER BROOKE DR BLDG 3600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT SAM HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78234-4504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-916-3774
Provider Business Mailing Address Fax Number:
210-916-6658

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3551 ROGER BROOKE DRIVE, BLDG 3600
Provider Second Line Business Practice Location Address:
BROOKE ARMY MEDICAL CENTER - DEPT OF SURGERY
Provider Business Practice Location Address City Name:
FT. SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-916-1153
Provider Business Practice Location Address Fax Number:
210-916-2202
Provider Enumeration Date:
03/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  22776 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208C00000X , with the licence number: 22776 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)