Healthcare Provider Details

I. General information

NPI: 1518974211
Provider Name (Legal Business Name): ROBERT E NOVAK PH.D./AUDIOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 FLOYD CURL DR 6TH FLOOR -6B
SAN ANTONIO TX
78229-3931
US

IV. Provider business mailing address

7703 FLOYD CURL DR MC7977
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-9950
  • Fax: 210-450-6033
Mailing address:
  • Phone: 210-450-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002268A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80422
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: