Theodore Trusevich, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

H4755 Issued in TX

Practice address

1626 E Common St
New Braunfels, TX 78130-3156

Phone

(830) 620-1272

Fax

(830) 620-1274

NPI assigned

Sep 22, 2005

Last updated

Oct 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1457347676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 E COMMON ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781303156",
            "telephone_number": "830-620-1272",
            "fax_number": "830-620-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 E COMMON ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781303156",
            "telephone_number": "830-620-1272",
            "fax_number": "830-620-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUSEVICH",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "H4755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.