Basic Information
| Provider Information | |||||||||
| NPI: | 1982909107 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GO | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | BERNAS | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7010 CHAMPIONS PLAZA DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770692395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818809180 | ||||||||
| FaxNumber: | 8326985171 | ||||||||
| Practice Location | |||||||||
| Address1: | 7010 CHAMPIONS PLAZA DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770692395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136204000 | ||||||||
| FaxNumber: | 7134584229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2011 | ||||||||
| LastUpdateDate: | 04/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | AP120139 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 280846101 | 05 | TX | MEDICAID | P00962835 | 01 | TX | RR MEDICARE | OTHER | 8506UB | 01 | TX | BCBS | OTHER | 280846402 | 05 | TX | MEDICAID |