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General NPI Number Information
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NPI Number | 1437346228
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Entity Type | Organization
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Legal Business Name | HUMBERTO R. BRUSCHETTA, M.D., P.A.
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 2511 E CORRAL AVE
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City | KINGSVILLE
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State | TX
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Zip | 78363-4101
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Country | US
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Telephone | 361-516-0097
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Fax | 361-516-0182
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Provider Business Mailing Address
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Address Line | 2511 EAST CORRAL AVE
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City | KINGSVILLE
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State | TX
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Zip | 78363-4101
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Country | US
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Telephone | 361-516-0097
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Fax | 361-516-0182
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Authorized Official
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Title or Position | OWNER
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Name | DR. HUMBERTO R BRUSCHETTA
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Credential | MD, FACP
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Telephone | 361-516-0097
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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 | 9634
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License Number State | TX
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