Provider Demographics
NPI:1255425039
Name:CATES, RONALD DWAYNE (MD PA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DWAYNE
Last Name:CATES
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S PALESTINE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751
Mailing Address - Country:US
Mailing Address - Phone:903-675-1717
Mailing Address - Fax:903-675-3338
Practice Address - Street 1:704 S PALESTINE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751
Practice Address - Country:US
Practice Address - Phone:903-675-1717
Practice Address - Fax:903-675-3338
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3220207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0089EGOtherBCBS
TXP000225L4Medicaid
TXP000225L4Medicaid
TX0089EGOtherBCBS