MEDICARE: JUAN P CATA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	57.010969	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417127929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN P CATA M.D.

Provider Business Mailing Address
First Line	:	4112 CASON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-3536
Country	:	US
Telephone Number	:	713-669-0149
Fax Number	:

Provider Business Practice Location Address
First Line	:	4112 CASON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005
Country	:	US
Telephone Number	:	713-669-0149
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/21/2012

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