Provider Demographics
NPI:1861674855
Name:KATSELNIK, DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:KATSELNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4118 POND HILL RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1281
Mailing Address - Country:US
Mailing Address - Phone:210-494-3739
Mailing Address - Fax:210-490-2164
Practice Address - Street 1:4118 POND HILL RD BLDG 3
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1281
Practice Address - Country:US
Practice Address - Phone:210-494-3739
Practice Address - Fax:210-490-2164
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1705207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine