Provider Demographics
NPI:1013569144
Name:KATARIA, PRANAV (DDS)
Entity Type:Individual
Prefix:
First Name:PRANAV
Middle Name:
Last Name:KATARIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 MAGNOLIA COVE DR APT 319
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2292
Mailing Address - Country:US
Mailing Address - Phone:713-505-2939
Mailing Address - Fax:
Practice Address - Street 1:2129 HIGHWAY 146 BYP
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:TX
Practice Address - Zip Code:77575-6000
Practice Address - Country:US
Practice Address - Phone:936-391-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103936122300000X
TX35694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist