Active NPI
Joseph John Novack III, M.D.
- Pediatrics Physician
- Fort Sam Houston, TX
National Provider Identifier
1811986854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 024832
- Practice address
- Brooke Army Medical Center
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504 - Phone
- (210) 539-9582
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 024832 | LA | Primary |
Addresses
Primary practice location
Brooke Army Medical Center
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Mailing address
Brooke Army Medical Center
3551 Roger Brooke Dr
Jbsa San Antonio, TX 78234-4504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024832 | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1811986854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BROOKE ARMY MEDICAL CENTER",
"address_2": "3551 ROGER BROOKE DR",
"city": "JBSA SAN ANTONIO",
"state": "TX",
"postal_code": "782344504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BROOKE ARMY MEDICAL CENTER",
"address_2": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-539-9582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVACK",
"first_name": "JOSEPH",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2021-08-31",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "024832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.