Provider Demographics
NPI:1487601779
Name:KING, KATHERINE YUDEH (MD PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:YUDEH
Last Name:KING
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 BATES AVE
Mailing Address - Street 2:SUITE 1150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2600
Mailing Address - Country:US
Mailing Address - Phone:832-824-1780
Mailing Address - Fax:832-825-1048
Practice Address - Street 1:1102 BATES AVE
Practice Address - Street 2:SUITE 1150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2600
Practice Address - Country:US
Practice Address - Phone:832-824-1780
Practice Address - Fax:832-825-1048
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3615208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G6931Medicare PIN
TXTXB110484Medicare PIN