Individual
KATHERINE YVONNE KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 8TH AVE, SUITE 240, FORT WORTH, TX 76104-4124
(817) 927-0456
(817) 927-4323
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 927-0456
(817) 927-4323
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
N5756
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
284128001
—
TX
01
—
284128002
CSHCN MEDICAID
TX
01
—
284128003
OUT OF COUNTY MEDICAID
TX
01
—
P00975530
RAILROAD MEDICARE
TX
Enumeration date
06/13/2007
Last updated
05/31/2013
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