MEDICARE: PIONEER PHYSICIAN SERVICES PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363AM0700X	Medical Physician Assistant
2	363L00000X	Nurse Practitioner
3	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1891937173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER PHYSICIAN SERVICES PA

Provider Business Mailing Address
First Line	:	200 CORPORATE BLVD
Second Line	:	SUITE 201
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3870
Country	:	US
Telephone Number	:	800-893-9698
Fax Number	:

Provider Business Practice Location Address
First Line	:	8445 MEMORIAL BLVD
Second Line	:	SUITE 600
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-7003
Country	:	US
Telephone Number	:	409-989-5400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL A PAWLOWSKI
Credential	:	MD
Telephone Number	:	800-893-9698

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	04/01/2009

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Directions to “PIONEER PHYSICIAN SERVICES PA ” Practice Location

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