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General NPI Number Information
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NPI Number | 1023393790
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Entity Type | Organization
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Legal Business Name | FREDERICK B NIEGOS MDPA
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 2700 CITIZENS PLAZA, SUITE 206
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City | VICTORIA
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State | TX
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Zip | 77901
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Country | US
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Telephone | 361-574-1870
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Fax | 361-574-1871
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Provider Business Mailing Address
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Address Line | 2700 CITIZENS PLAZA, SUITE 206
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City | VICTORIA
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State | TX
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Zip | 77901
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Country | US
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Telephone | 361-574-1870
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Fax | 361-574-1871
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Authorized Official
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Title or Position | OWNER
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Name | DR. FREDERICK B. NIEGOS
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Credential | M.D.
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Telephone | 361-574-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 053344
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License Number State | GA
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