Katherine Wentworth, PA-C
Physician Assistant in Georgetown, TX. Individual provider (NPI-1).
NPI number1265002141
StatusActive
Last updated in NPPESJul 1, 2021
Details
- NPI
- 1265002141
- Entity type
- Individual (NPI-1)
- Name
- Ms. Katherine Wentworth
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2021
- Certification date
- Jun 11, 2021
- Last updated
- Jul 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA14249 | TX | Yes |
Practice location
1900 Scenic Dr Ste 2220Georgetown, TX 78626-7703
Phone 512-819-0132 · Fax 512-819-9335
Mailing address
Po Box 679706Dallas, TX 75267-9706
Phone 512-792-4402 · Fax 512-792-4420
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