Provider Demographics
NPI:1740891225
Name:BOREN, KATY LAYNE (MPAS, PA-C)
Entity type:Individual
Prefix:MISS
First Name:KATY
Middle Name:LAYNE
Last Name:BOREN
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 EIGEL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3417
Mailing Address - Country:US
Mailing Address - Phone:713-960-1311
Mailing Address - Fax:832-653-6407
Practice Address - Street 1:27150 HIGHWAY 290 STE 100
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7224
Practice Address - Country:US
Practice Address - Phone:832-653-3300
Practice Address - Fax:832-653-6407
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15024363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1841756236OtherGROUP NPI