Provider Demographics
NPI:1407838212
Name:NASIOTIS, THEODORE (PA)
Entity Type:Individual
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First Name:THEODORE
Middle Name:
Last Name:NASIOTIS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:300 W CENTRAL TEXAS EXPY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1885
Mailing Address - Country:US
Mailing Address - Phone:254-833-8456
Mailing Address - Fax:254-833-9162
Practice Address - Street 1:300 W CENTRAL TEXAS EXPY
Practice Address - Street 2:SUITE 115
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1885
Practice Address - Country:US
Practice Address - Phone:254-833-8456
Practice Address - Fax:254-833-9162
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-12-01
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant