Provider Demographics
NPI:1497885560
Name:PITTY, CATALINO G (LSA)
Entity Type:Individual
Prefix:MR
First Name:CATALINO
Middle Name:G
Last Name:PITTY
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 680366
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268-0366
Mailing Address - Country:US
Mailing Address - Phone:713-254-6136
Mailing Address - Fax:281-893-0780
Practice Address - Street 1:2522 SANDLEWOOD TRAIL LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1963
Practice Address - Country:US
Practice Address - Phone:713-254-6136
Practice Address - Fax:281-893-0780
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00279246ZC0007X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00279OtherLICENSE SURGICAL ASSISTANT