Provider Demographics
NPI:1285930750
Name:LANGSTON, KATI LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:KATI
Middle Name:LYNN
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATI
Other - Middle Name:LYNN
Other - Last Name:SCHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1725 BIRMINGHAM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4064
Mailing Address - Country:US
Mailing Address - Phone:979-696-8000
Mailing Address - Fax:979-696-8100
Practice Address - Street 1:1725 BIRMINGHAM RD STE 200
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845
Practice Address - Country:US
Practice Address - Phone:979-696-8000
Practice Address - Fax:979-696-8100
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07139363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA07139OtherLICENSE