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General NPI Number Information
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NPI Number | 1033175039
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Entity Type | Organization
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Legal Business Name | S E NOWOTNY DO PA
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 5607 EVERHART RD
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-4904
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Country | US
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Telephone | 361-854-4601
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Fax | 361-371-8376
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Provider Business Mailing Address
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Address Line | PO BOX 61160
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City | CORPUS CHRISTI
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State | TX
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Zip | 78466-1160
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Country | US
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Telephone | 361-884-2904
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Fax | 361-371-8376
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN E NOWOTNY
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Credential | MD
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Telephone | 361-929-6960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K7848
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License Number State | TX
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