Provider Demographics
NPI:1366601437
Name:HOGAN, KATHLEEN MARGARET (PA-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARGARET
Last Name:HOGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 KIRBY DR STE 601
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3933
Mailing Address - Country:US
Mailing Address - Phone:713-581-9119
Mailing Address - Fax:713-489-7096
Practice Address - Street 1:3730 KIRBY DR STE 601
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3933
Practice Address - Country:US
Practice Address - Phone:713-581-9119
Practice Address - Fax:713-489-7096
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K9770Medicare PIN