Provider Demographics
NPI:1952595753
Name:DAVID J KATRANA DDS,MD,PA
Entity Type:Organization
Organization Name:DAVID J KATRANA DDS,MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:KATRANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-805-4870
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0128
Mailing Address - Country:US
Mailing Address - Phone:281-833-3330
Mailing Address - Fax:281-833-3327
Practice Address - Street 1:215 LEATHER LEAF
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2129
Practice Address - Country:US
Practice Address - Phone:713-805-4870
Practice Address - Fax:281-833-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081033501Medicaid
TX00707KOtherBLUE CROSS/BLUE SHEILD
TX081033501Medicaid