MEDICARE: DR. THOMAS E PIWONKA M.D.

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	207L00000X	Anesthesiology Physician	H2692	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1861582181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS E PIWONKA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 293716
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75029-3716
Country	:	US
Telephone Number	:	214-288-7262
Fax Number	:	817-430-8686

Provider Business Practice Location Address
First Line	:	1854 LAKEPOINTE DR
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-6442
Country	:	US
Telephone Number	:	214-288-7262
Fax Number	:

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

Provider Enumeration Date	:	10/15/2006
Last Update Date	:	02/05/2008

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