Provider Demographics
NPI:1205478989
Name:CALDWELL, KATHRYN E (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:E
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 GETTYSBURG LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2300
Mailing Address - Country:US
Mailing Address - Phone:817-308-8537
Mailing Address - Fax:
Practice Address - Street 1:13500 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5124
Practice Address - Country:US
Practice Address - Phone:214-360-9044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38215103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist