1316186612 NPI number — JOHN JOSEPH NAVA SR. M.D.

Table of content: JOHN JOSEPH NAVA SR. M.D. (NPI 1316186612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316186612 NPI number — JOHN JOSEPH NAVA SR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAVA
Provider First Name:
JOHN
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
Provider Name Suffix Text:
SR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NAVA
Provider Other First Name:
JOHN
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1316186612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
332 W COMMERCE ST
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78205-2409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-207-8731
Provider Business Mailing Address Fax Number:
210-207-2160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
814 MCCULLOUGH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78215-1625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-207-8823
Provider Business Practice Location Address Fax Number:
210-228-0155
Provider Enumeration Date:
02/10/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  H4572 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2083P0901X , with the licence number: H4572 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 130765402 . This is a "TPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".