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General NPI Number Information
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NPI Number | 1902672462
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Entity Type | Individual
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Provider Name | KATTY MARIA LORANAVA
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Gender | Female
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 3599 WINFIELD RD ROOM 3401
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City | SAN ANTONIO
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State | TX
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Zip | 78234
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Country | US
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Telephone | 210-221-6687
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 N LOOP 1604 W APT 12207
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City | SAN ANTONIO
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State | TX
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Zip | 78257-4433
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Country | US
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Telephone | 808-202-1244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2222
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License Number State | TX
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