Doctor Name: | JAMES COVELLI |
NPI Number: | 1467794164 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 28085 |
Business Practice Address: | 3551 Roger Brooke Dr Jbsa Ft Sam Houston, TX - 782344504 |
Business Phone Number: | 2109163290 |
Business Fax Number: | |
Mailing Address: | 3551 Roger Brooke Dr, JBSA FT SAM HOUSTON |
State: | TX |
Postal Code: | 782344504 |
Phone Number: | 2109163290 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2013 |
NPI Last Update Date: | 01/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 28085 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |