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General NPI Number Information
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NPI Number | 1447251905
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Entity Type | Individual
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Provider Name | BOGUSLAW GODLEWSKI MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 1330 WONDER WORLD DR STE B108
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City | SAN MARCOS
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State | TX
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Zip | 78666-7566
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Country | US
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Telephone | 512-396-5603
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Fax | 512-396-5623
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Provider Business Mailing Address
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Address Line | AUSTIN HEART PLLC PO BOX 402669
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City | ATLANTA
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State | GA
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Zip | 30384-2669
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Country | US
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Telephone | 512-206-4300
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Fax | 512-206-4350
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E4848
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License Number State | TX
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