Organization
ANDREW B CIVITELLO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE CATHY CIVITELLO PA-C (ADMINISTRATOR)
(713) 526-8900
Entity
Organization
Contact information
Practice address
1200 BINZ ST, SUITE 1290, HOUSTON, TX 77004-6900
(713) 526-8900
(713) 526-8901
Mailing address
1200 BINZ ST, SUITE 1290, HOUSTON, TX 77004-6900
(713) 526-8900
(713) 526-8901
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
K4661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191438401
—
TX
Enumeration date
11/09/2007
Last updated
05/25/2010
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