Individual
MRS. KATHARINE FISKE LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA07880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310007501
—
TX
05
—
310007502
—
TX
01
—
P01808897
RAILROAD
TX
Enumeration date
12/15/2008
Last updated
10/26/2021
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