Provider Demographics
NPI:1861897472
Name:GEORGE, KATHERINE (CNIM)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNIM
Mailing Address - Street 1:5080 SPECTRUM DR UNIT 1100
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:877-934-2333
Mailing Address - Fax:
Practice Address - Street 1:5080 SPECTRUM DR UNIT 1100
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4648
Practice Address - Country:US
Practice Address - Phone:877-934-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3733246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic