Individual
IVAN ROBERT NEPUSTIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 HAYS ST STE D, LULING, TX 78648-3207
(830) 875-3445
Mailing address
130 HAYS ST STE D, LULING, TX 78648-3207
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M6797
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1921874
—
LA
Enumeration date
07/25/2006
Last updated
06/13/2015
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