Provider Demographics
NPI:1083504773
Name:PERGUSON, KATARINA MORGAN
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:MORGAN
Last Name:PERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATARINA
Other - Middle Name:ESPERANZA
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2391 NE LOOP 410 STE 304
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5675
Mailing Address - Country:US
Mailing Address - Phone:210-591-8999
Mailing Address - Fax:
Practice Address - Street 1:2391 NE LOOP 410
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5600
Practice Address - Country:US
Practice Address - Phone:210-591-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-23-301665106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician