Provider Demographics
NPI:1619328531
Name:AGIRI, KATHY
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:AGIRI
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 1:5807 EDEN CREST CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1618
Mailing Address - Country:US
Mailing Address - Phone:832-264-5932
Mailing Address - Fax:
Practice Address - Street 1:1855 GATTIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-7428
Practice Address - Country:US
Practice Address - Phone:512-238-6268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2025-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN771906207Q00000X
NM73459207Q00000X
OH0033510207Q00000X
FLAPRN11017414207Q00000X
TX129726363LF0000X
AZ2900130207Q00000X
TN30926207Q00000X
MN10261363LF0000X
MACOND2374574207Q00000X
CTRN15273261QM2500X
VA0024184951207Q00000X
NJ26NJ150158000261QM2500X
KS53-80878-031207Q00000X
DELG-0012611207Q00000X
IAA167152207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty