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Organization
BAY CARDIOVASCULAR SURGERY PA
Active
Organization
BAY CARDIOVASCULAR SURGERY PA
Active
Other names
Bay Vascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
LOFTON NATHANIEL MISICK M.D. (OWNER)
(361) 761-8610
Entity
Organization
Contact information
Practice address
819 AYERS ST, CORPUS CHRISTI, TX 78404-1914
(361) 761-8610
(361) 761-8611
Mailing address
ID#1177, PO BOX 659506, SAN ANTONIO, TX 78265-9506
(361) 761-8610
(361) 761-8611
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Q7428
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367177801
—
TX
Enumeration date
09/27/2016
Last updated
08/29/2022
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