Provider Demographics
NPI:1386112704
Name:PAPAIOANNOU, KAITLIN ANDERSON (PA-C)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ANDERSON
Last Name:PAPAIOANNOU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:7400 FANNIN ST STE 1295
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1934
Practice Address - Country:US
Practice Address - Phone:832-377-3770
Practice Address - Fax:713-341-1574
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX405188003Medicaid
TX405188004Medicaid