Provider Demographics
NPI:1972548642
Name:TOEPPERWEIN MED-CLINIC LTD
Entity Type:Organization
Organization Name:TOEPPERWEIN MED-CLINIC LTD
Other - Org Name:TOEPPERWEIN MEDICAL CLINIC LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-599-3840
Mailing Address - Street 1:11901 TOEPPERWEIN RD
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3161
Mailing Address - Country:US
Mailing Address - Phone:210-599-3840
Mailing Address - Fax:210-599-1713
Practice Address - Street 1:11901 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 1402
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3161
Practice Address - Country:US
Practice Address - Phone:210-599-3840
Practice Address - Fax:210-599-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00006HMedicare PIN