MEDICARE: JOSEPH J NOVACK II FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP132831	TX

General Provider Information

NPI Number	:	1770028573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH J NOVACK II FNP-C

Provider Business Mailing Address
First Line	:	117 E CASTLE LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1802
Country	:	US
Telephone Number	:	210-488-8737
Fax Number	:

Provider Business Practice Location Address
First Line	:	6051 FM 3009 STE 210
Second Line	:
City	:	SCHERTZ
State	:	TX
Zip	:	78154-3473
Country	:	US
Telephone Number	:	210-299-7770
Fax Number	:	833-502-1747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	10/09/2025

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