# BAY CARDIOVASCULAR SURGERY PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bay Vascular Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831648203
- **Authorized official:** LOFTON NATHANIEL MISICK M.D. (OWNER)
- **Authorized official phone:** (361) 761-8610

## Contact information

- **Practice address:** 819 AYERS ST, CORPUS CHRISTI, TX 78404-1914
- **Practice address phone:** (361) 761-8610
- **Practice address fax:** (361) 761-8611
- **Mailing address:** ID\#1177, PO BOX 659506, SAN ANTONIO, TX 78265-9506
- **Mailing address phone:** (361) 761-8610
- **Mailing address fax:** (361) 761-8611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |
| 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

- **Enumeration date:** 09/27/2016
- **Last updated:** 08/29/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 367177801 | — | TX |