Basic Information
| Provider Information | |||||||||
| NPI: | 1073264495 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIU | ||||||||
| FirstName: | KATHARINE | ||||||||
| MiddleName: | ALLYSON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4208 AVENUE C | ||||||||
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| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787513707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547226523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 919 E 32ND ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787052703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125447111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2022 | ||||||||
| LastUpdateDate: | 08/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 1066265 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.