Provider Demographics
NPI:1528173580
Name:AGARWAL, KATHRYN S (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:S
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 N. MACGREGOR WAY, RM AD-105
Mailing Address - Street 2:MEDICINE-GERIATRICS, BCM 285, QUENTIN MEASE
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:713-873-4885
Mailing Address - Fax:713-873-4896
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-798-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8869207R00000X, 207RG0300X
MA205578207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AG683OtherBCBS
TXP00738025OtherRAILROAD INDIVIDUAL MEDICARE
TX188412401Medicaid
TX8AG683OtherBCBS
TXP00738025OtherRAILROAD INDIVIDUAL MEDICARE
TX188412401Medicaid
TX8L3748Medicare PIN
TXTXB111823Medicare PIN