Provider Demographics
NPI:1457539165
Name:ZEDAN, KATRINA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:
Last Name:ZEDAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 BINZ ST
Mailing Address - Street 2:STE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7296
Mailing Address - Country:US
Mailing Address - Phone:210-358-1654
Mailing Address - Fax:210-358-4775
Practice Address - Street 1:527 N LEONA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3110
Practice Address - Country:US
Practice Address - Phone:210-358-1654
Practice Address - Fax:210-358-4775
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05544363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant