| |
5607 Everhart Rd Corpus Christi TX 78411-4904 | |
(361) 854-4601 | |
(361) 371-8376 |
Full Name | |
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Speciality | Family Medicine |
Location | 5607 Everhart Rd, Corpus Christi, Texas |
Authorized Official Name and Position | Steven E Nowotny (OWNER) |
Authorized Official Contact | 3619296960 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 61160 Corpus Christi TX 78466-1160 Ph: (361) 884-2904 | 5607 Everhart Rd Corpus Christi TX 78411-4904 Ph: (361) 854-4601 |
NPI Number | 1033175039 |
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Provider Enumeration Date | 04/26/2006 |
Last Update Date | 09/24/2024 |
Medicare PECOS PAC ID | 1052847571 |
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Medicare Enrollment ID | O20241208000017 |
Identifier | Type | State | Issuer |
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1033175039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | K7848 (Texas) | Primary |
Provider Name | Steven Ernest Nowotny |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013973015 PECOS PAC ID: 0042241416 Enrollment ID: I20110112000432 |
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