MEDICARE: BALDEMAR COVARRUBIAS M.D., PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	H4253	TX

General Provider Information

NPI Number	:	1689697096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALDEMAR COVARRUBIAS M.D., PA

Provider Business Mailing Address
First Line	:	5718 SPOHN DR
Second Line	:	SUITE 100
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4116
Country	:	US
Telephone Number	:	361-980-0808
Fax Number	:	361-653-7041

Provider Business Practice Location Address
First Line	:	5718 SPOHN DR
Second Line	:	SUITE 100
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4116
Country	:	US
Telephone Number	:	361-980-0808
Fax Number	:	361-653-7041

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	BALDEMAR COVARRUBIAS
Credential	:	M.D.
Telephone Number	:	361-980-0808

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	01/30/2024

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