Individual
KATIE COLLEEN PEDICORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8230 WALNUT HILL LN, SUITE 808, DALLAS, TX 75231-4482
(214) 696-8828
(214) 696-1444
Mailing address
8230 WALNUT HILL LN, SUITE 808, DALLAS, TX 75231-4482
(214) 696-8828
(214) 696-1444
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04430
TX
363AS0400X
Surgical Physician Assistant
PA04430
TX
Other
Enumeration date
08/28/2006
Last updated
08/27/2024
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