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NPI Code Detail

MEDICARE: DR. ALFREDO NODARSE M.D.

MEDICARE: DR. ALFREDO NODARSE M.D.
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
1207R00000XInternal Medicine PhysicianD2905TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110041038OTHERTXRAILROAD MEDICARE

General Provider Information

NPI Number : 1750375788
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO NODARSE M.D.
Provider Business Mailing Address
First Line : 7111 MEDICAL CENTER DRIVE
Second Line : SUITE 200
City : TEXAS CITY
State : TX
Zip : 77591-2546
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7111 MEDICAL CENTER DRIVE
Second Line : SUITE 200
City : TEXAS CITY
State : TX
Zip : 77591-2546
Country : US
Telephone Number : 409-948-8521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 07/30/2013

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