Provider Demographics
NPI:1932277225
Name:EWA K. NIEWIAROWSKI MD PLLC
Entity Type:Organization
Organization Name:EWA K. NIEWIAROWSKI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EWA
Authorized Official - Middle Name:KRYSTYNA
Authorized Official - Last Name:NIEWIAROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-981-3840
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:972-981-3840
Mailing Address - Fax:972-981-3842
Practice Address - Street 1:6300 W PARKER RD
Practice Address - Street 2:MOB 2 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5990384001OtherCIGNA
TX0100543OtherUHC
TX5299583OtherAETNA
TX0010JQOtherBCBS
TX0100543OtherUHC
TX00960UMedicare ID - Type Unspecified