Provider Demographics
NPI:1578663563
Name:PEDIATRIC CENTER OF ROUND ROCK
Entity Type:Organization
Organization Name:PEDIATRIC CENTER OF ROUND ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:KATALENAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-733-5437
Mailing Address - Street 1:7700 CAT HOLLOW DR
Mailing Address - Street 2:UNIT 104
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5796
Mailing Address - Country:US
Mailing Address - Phone:512-733-5437
Mailing Address - Fax:512-244-1861
Practice Address - Street 1:7700 CAT HOLLOW DR
Practice Address - Street 2:UNIT 104
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5796
Practice Address - Country:US
Practice Address - Phone:512-733-5437
Practice Address - Fax:512-244-1861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty