Provider Demographics
NPI:1366802548
Name:KRATTENMAKER, KARRIE BUTLER (PA-C, ATC)
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:BUTLER
Last Name:KRATTENMAKER
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 ROGERS XING STE 308
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4776
Mailing Address - Country:US
Mailing Address - Phone:210-598-5605
Mailing Address - Fax:
Practice Address - Street 1:10010 ROGERS XING STE 308
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4776
Practice Address - Country:US
Practice Address - Phone:210-598-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA16950363A00000X
UT11273906-48102255A2300X
UT11273906-1206363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program