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General NPI Number Information
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NPI Number | 1386803104
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Entity Type | Organization
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Legal Business Name | HOWDY INTERNAL MEDICINE
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 104 TURNER LN
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City | FLORESVILLE
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State | TX
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Zip | 78114-3171
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Country | US
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Telephone | 830-393-7771
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Fax | 830-393-7775
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Provider Business Mailing Address
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Address Line | 104 TURNER LN
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City | FLORESVILLE
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State | TX
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Zip | 78114-3171
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Country | US
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Telephone | 830-393-7771
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Fax | 830-393-7775
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Authorized Official
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Title or Position | MD
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Name | DR. MARK EDWARD HENNESSY
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Credential | MD
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Telephone | 830-393-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9500093
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License Number State | NC
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