Individual
DR. KATHLEEN ELISE CAMMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1250 8TH AVE STE 440, FORT WORTH, TX 76104-4144
(817) 502-8484
(817) 212-7019
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
Q7156
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358904601
—
TX
Enumeration date
04/09/2012
Last updated
02/28/2020
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