Provider Demographics
NPI:1245380195
Name:NIEWIAROWSKI, EWA KRYSTYNA (MD)
Entity type:Individual
Prefix:DR
First Name:EWA
Middle Name:KRYSTYNA
Last Name:NIEWIAROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 TRAILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6023
Mailing Address - Country:US
Mailing Address - Phone:214-497-0640
Mailing Address - Fax:972-981-3842
Practice Address - Street 1:6300 W PARKER RD
Practice Address - Street 2:MOB2 SUITE 422
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8100
Practice Address - Country:US
Practice Address - Phone:972-981-3840
Practice Address - Fax:972-981-3842
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0100543OtherUHC
TX5990384001OtherCIGNA
TX8H1020OtherBCBS
TX5299583OtherAETNA
TX5990384001OtherCIGNA
G78831Medicare UPIN