MEDICARE: THOMAS E PIWONKA, MD, 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	207L00000X	Anesthesiology Physician	H2692	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689862377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS E PIWONKA, MD, PA

Provider Business Mailing Address
First Line	:	PO BOX 293716
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75029-3716
Country	:	US
Telephone Number	:	866-397-4219
Fax Number	:	940-458-2902

Provider Business Practice Location Address
First Line	:	1854 LAKEPOINTE DR
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-6442
Country	:	US
Telephone Number	:	866-397-4219
Fax Number	:	940-458-2902

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. THOMAS E PIWONKA
Credential	:	MD
Telephone Number	:	214-288-7262

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	02/06/2008

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