Individual
KATHERINE ELIZABETH THALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
120 HILLCREST MEDICAL BLVD STE 100, WACO, TX 76712-8949
(254) 202-6100
(254) 202-6195
Mailing address
PO BOX 848476, DALLAS, TX 75284-8476
(254) 202-4655
(254) 202-4697
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L4145
TX
Other
Enumeration date
05/20/2014
Last updated
12/30/2020
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