Basic Information
| Provider Information | |||||||||
| NPI: | 1003805623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIERSACK | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | EMILY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3103 SABLE CRK | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782592636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104811808 | ||||||||
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| Practice Location | |||||||||
| Address1: | 221 3RD ST W | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH A F B | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781504800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106529626 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 0101042319 | VA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.