MEDICARE: DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP

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	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0082MA	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1710938378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP

Provider Business Mailing Address
First Line	:	1902 MORGAN AVE
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78404-3554
Country	:	US
Telephone Number	:	361-887-6699
Fax Number	:	361-888-5117

Provider Business Practice Location Address
First Line	:	1902 MORGAN AVE
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78404-3554
Country	:	US
Telephone Number	:	361-887-6699
Fax Number	:	361-888-5117

Authorized Official
Title or Position	:	PRESIDENT/ADMINISTRATOR
Name	:	DERRICK PARKER
Credential	:
Telephone Number	:	361-694-5081

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/22/2020

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Directions to “DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP ” Practice Location

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