Provider Demographics
NPI:1063961340
Name:UECKERT, KATE MERLEN
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:MERLEN
Last Name:UECKERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:UECKERT
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:629 S CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77418-2801
Mailing Address - Country:US
Mailing Address - Phone:979-472-0049
Mailing Address - Fax:
Practice Address - Street 1:1348 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-2129
Practice Address - Country:US
Practice Address - Phone:979-472-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor