Healthcare Provider Details

I. General information

NPI: 1114615416
Provider Name (Legal Business Name): ROBERT M KATZ MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SHULT DR
COLUMBUS TX
78934-3016
US

IV. Provider business mailing address

1905 MILAM ST
COLUMBUS TX
78934-2941
US

V. Phone/Fax

Practice location:
  • Phone: 979-732-2318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT KATZ
Title or Position: OWNER
Credential:
Phone: 979-732-2318