Provider Demographics
NPI:1821132903
Name:KATZ, BERNARD (NMN) (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:(NMN)
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 HILLCROFT ST.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1091
Mailing Address - Country:US
Mailing Address - Phone:713-772-3783
Mailing Address - Fax:713-772-3784
Practice Address - Street 1:6065 HILLCROFT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1087
Practice Address - Country:US
Practice Address - Phone:713-772-3783
Practice Address - Fax:713-772-3784
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72821223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT14129Medicare UPIN
TX00C985Medicare ID - Type Unspecified