Provider Demographics
NPI:1013141605
Name:HOWARD M. KATZ MD P.A.
Entity type:Organization
Organization Name:HOWARD M. KATZ MD P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-872-1133
Mailing Address - Street 1:PO BOX 4200
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75712-4200
Mailing Address - Country:US
Mailing Address - Phone:903-591-6644
Mailing Address - Fax:903-324-6496
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2471
Practice Address - Country:US
Practice Address - Phone:903-872-1133
Practice Address - Fax:903-872-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9521207Q00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209155501Medicaid
TXDP7532OtherRAILROAD MEDICARE
TX044096802Medicaid
TX209155502Medicaid
TXDP7532OtherRAILROAD MEDICARE
TXP00231070Medicare PIN
TXC72457Medicare UPIN
TX209155501Medicaid