Joseph Novosel, DPM

Individual provider Active NPI Podiatrist · Beaumont, TX

NPI 1669488128 · NPPES record last updated Jul 11, 2008

Key facts

NPI
1669488128
Entity type
Individual (NPI type 1)
Primary specialty
Podiatrist 213E00000X
License
0564 (TX)
Practice address
2850 Eastex Fwy
Beaumont, TX 77703-4618
Phone
(409) 899-1340
Fax
(409) 899-5184
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
564LAMDChiropractor
0564TXMDPodiatrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0564 TX Yes

Addresses

Primary practice location

2850 Eastex Fwy
Beaumont, TX 77703-4618

Mailing address

2850 Eastex Fwy
Beaumont, TX 77703-4618
Phone (409) 899-1340

Other identifiers

IdentifierTypeStateIssuer
00AM11OtherTXMEDICARE PTAN
000812001MedicaidTX

Other providers in Beaumont, TX

All providers in Beaumont, TX · Podiatrist in Texas

Sources for this page

Verify at the official NPI Registry.