Provider Demographics
NPI:1629728886
Name:MUSCARELLA, KAITLYN ROSE (MD)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ROSE
Last Name:MUSCARELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ROSE
Other - Last Name:KEENAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN ST STE 5.170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6113
Mailing Address - Fax:713-500-0648
Practice Address - Street 1:6431 FANNIN ST STE 5.170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6113
Practice Address - Fax:713-500-0684
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program