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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
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Q7428
TX
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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