Provider Demographics
NPI:1215268065
Name:ENRIGHT, KATHY LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:ENRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1102 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-3208
Mailing Address - Country:US
Mailing Address - Phone:972-841-5352
Mailing Address - Fax:979-543-4137
Practice Address - Street 1:305 SANDY CORNER RD
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437
Practice Address - Country:US
Practice Address - Phone:979-543-5510
Practice Address - Fax:979-543-4137
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01052363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S95884Medicare UPIN