Individual
MRS. KATHILEEN RILEY BOOZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
7125 NEW SANGER AVE STE 502, WACO, TX 76712-4054
(254) 343-7919
(254) 459-3711
Mailing address
7125 NEW SANGER AVE STE 502, WACO, TX 76712-4054
(254) 343-7919
(254) 459-3711
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
AP121522
TX
363L00000X
Nurse Practitioner
762114
TX
363L00000X
Nurse Practitioner
AP121522
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111521403
—
TX
Enumeration date
05/14/2012
Last updated
05/28/2025
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