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General NPI Number Information
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NPI Number | 1407171796
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Entity Type | Organization
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Legal Business Name | AMY D. CIBOROWSKI, MD,PA
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 200 N CHERRY ST
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City | TOMBALL
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State | TX
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Zip | 77375-4704
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Country | US
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Telephone | 281-351-5367
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Fax | 281-351-5368
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Provider Business Mailing Address
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Address Line | PO BOX 1451
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City | TOMBALL
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State | TX
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Zip | 77377-1451
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Country | US
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Telephone | 281-351-5367
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Fax | 281-351-5368
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY D CIBOROWSKI
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Credential | M.D.
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Telephone | 281-351-5367
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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 | G4983
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License Number State | TX
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