Provider Demographics
NPI:1174193718
Name:CERNA, CATHERINE ELISE (DDS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELISE
Last Name:CERNA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3823 BUFFALO SPEEDWAY APT 2302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3723
Mailing Address - Country:US
Mailing Address - Phone:432-940-0552
Mailing Address - Fax:
Practice Address - Street 1:650 MEYERLAND PLAZA MALL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1617
Practice Address - Country:US
Practice Address - Phone:832-551-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-27
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice