Provider Demographics
NPI:1205028347
Name:NESTOR C. PUNAY, MD.,P.A
Entity Type:Organization
Organization Name:NESTOR C. PUNAY, MD.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER, CFO
Authorized Official - Prefix:
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:NOVAL
Authorized Official - Last Name:DEMECILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-347-1600
Mailing Address - Street 1:755 N 11TH ST
Mailing Address - Street 2:SUITE P3900
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1500
Mailing Address - Country:US
Mailing Address - Phone:409-347-1600
Mailing Address - Fax:409-347-1608
Practice Address - Street 1:755 N 11TH ST
Practice Address - Street 2:SUITE P3900
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1500
Practice Address - Country:US
Practice Address - Phone:409-347-1600
Practice Address - Fax:409-347-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL98562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00651XMedicare PIN