Provider Demographics
NPI:1972540409
Name:CATALENA, LORIN V (PA)
Entity Type:Individual
Prefix:
First Name:LORIN
Middle Name:V
Last Name:CATALENA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10194
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77842-0194
Mailing Address - Country:US
Mailing Address - Phone:979-693-6000
Mailing Address - Fax:979-693-1900
Practice Address - Street 1:1730 BIRMINGHAM DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-4063
Practice Address - Country:US
Practice Address - Phone:979-693-6000
Practice Address - Fax:979-693-1900
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02960363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D9983OtherMEDICARE
TX8D9983OtherMEDICARE