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NPI Code Detail

MEDICARE: DR. GINNA NELSON MD

MEDICARE: DR. GINNA NELSON MD
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
1207Q00000XFamily Medicine PhysicianJ4385TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841208543
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GINNA NELSON MD
Provider Business Mailing Address
First Line : PO BOX 29
Second Line :
City : FISCHER
State : TX
Zip : 78623-0029
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 506 E SAN ANTONIO ST
Second Line :
City : VICTORIA
State : TX
Zip : 77901-6060
Country : US
Telephone Number : 361-788-6680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 05/05/2008

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