Katherine Louise Dougherty, PA-C

Individual provider Active NPI Physician Assistant · Comfort, TX

NPI 1447658307 · NPPES record last updated Jun 22, 2016

Key facts

NPI
1447658307
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
212 US Highway 87
Comfort, TX 78013-3705
Phone
(830) 995-3887
Fax
(830) 995-3393
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

212 US Highway 87
Comfort, TX 78013-3705

Mailing address

1510 S Main St
Boerne, TX 78006-3308
Phone (830) 816-4357

Other identifiers

IdentifierTypeStateIssuer
8977NMOtherTXBC PIN
P01529987OtherTXRR MEDICARE PTAN

Other providers in Comfort, TX

All providers in Comfort, TX · Physician Assistant in Texas

Sources for this page

Verify at the official NPI Registry.