Individual
KATHLEEN PROVENCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
4545 POST OAK PLACE DR, SUITE 130, HOUSTON, TX 77027-3164
(713) 960-8008
(713) 960-0965
Mailing address
2521 BREAUX TRCE, SEABROOK, TX 77586-3397
(281) 532-2118
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
636908
TX
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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