Provider Demographics
NPI:1386741171
Name:KATALENAS, MARTA MARIA (MD)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:MARIA
Last Name:KATALENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7700 CAT HOLLOW DR
Mailing Address - Street 2:UNIT 104
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5796
Mailing Address - Country:US
Mailing Address - Phone:512-733-5437
Mailing Address - Fax:512-244-1861
Practice Address - Street 1:7700 CAT HOLLOW DR
Practice Address - Street 2:UNIT 104
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5796
Practice Address - Country:US
Practice Address - Phone:512-733-5437
Practice Address - Fax:512-244-1861
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK1495208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092187602Medicaid
TX092187601Medicaid
TX092187602Medicaid