Provider Demographics
NPI:1588122436
Name:REICHARDT, KATRINA
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:REICHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7518 QUIET FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-2625
Mailing Address - Country:US
Mailing Address - Phone:832-377-9425
Mailing Address - Fax:
Practice Address - Street 1:3308 ELLA BLVD STE L
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7336
Practice Address - Country:US
Practice Address - Phone:832-377-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG