Provider Demographics
NPI:1174509053
Name:NAWROCKI, JOSEPH W (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:NAWROCKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1635
Mailing Address - Country:US
Mailing Address - Phone:817-480-5111
Mailing Address - Fax:
Practice Address - Street 1:3301 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2908
Practice Address - Country:US
Practice Address - Phone:972-758-3598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5847207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128751806Medicaid
TX8B7000OtherBCBS
TX930045360OtherRAILROAD
TX930045360OtherMEDICARE RAILROAD
TX8B7000OtherBCBS
TX930045360OtherRAILROAD