Provider Demographics
NPI:1275032724
Name:CATALINE, NEIL MARTIN (IDC)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:MARTIN
Last Name:CATALINE
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 BINZ ENGLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78219-2219
Mailing Address - Country:US
Mailing Address - Phone:210-539-9926
Mailing Address - Fax:
Practice Address - Street 1:3837 BINZ ENGLEMAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219-2219
Practice Address - Country:US
Practice Address - Phone:210-539-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman