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Organization

DR TED KOVACEV MD PA

Active
Other names
Ted Kovacev MD
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANE BROOKE KOVACEV (PRACTICE MANAGER)
(979) 721-7007
Entity
Organization

Contact information

Practice address
104 CIRCLE WAY ST STE A, LAKE JACKSON, TX 77566-5200
(979) 721-7007
(979) 721-4254
Mailing address
104 CIRCLE WAY ST STE A, LAKE JACKSON, TX 77566-5200
(979) 721-7007
(979) 721-4254

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4042707-01
TX
Enumeration date
09/26/2019
Last updated
05/04/2022
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