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NPI 1205940012

NPI 1205940012 : KEVIN KATZ OD PC : GALVESTON, TX

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General NPI Number Information
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    NPI Number           |    1205940012
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    Entity Type          |    Organization 
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    Legal Business Name  |    KEVIN KATZ OD PC 
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Dates
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    Enumeration Date     |    08/18/2006
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    Last Update Date     |    11/20/2010
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Provider Practice Location Address
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    Address Line         |    515 22ND ST 
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    City                 |    GALVESTON
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    State                |    TX
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    Zip                  |    77550-1922
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    Country              |    US
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    Telephone            |    409-762-8679
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    Fax                  |    409-762-2821
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Provider Business Mailing Address
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    Address Line         |    515 22ND ST 
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    City                 |    GALVESTON
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    State                |    TX
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    Zip                  |    77550-1922
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    Country              |    US
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    Telephone            |    409-762-8679
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    Fax                  |    409-762-2821
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     KEVIN  KATZ 
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    Credential           |    O.D.
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    Telephone            |    409-762-8679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    0257TG
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    License Number State |    TX
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