Potepalov, Sergey Sergeyevich

Potepalov, Sergey Sergeyevich is an individual health care provider with primary practice located at 500 W Medical Center Blvd Department Of Emergency Medicine, Webster TX 77598-4220. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Potepalov, Sergey Sergeyevich can be contacted via phone (281) 338-3708.

Contact Information

Primary practice address
500 W Medical Center Blvd Department Of Emergency Medicine Webster TX 77598-4220
Phone: (281) 338-3708
Fax: (281) 338-3224
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD.20529 Louisiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X P9695 Texas

Profile Details

NPI number 1215255633
LBN Legal business name Potepalov, Sergey Sergeyevich
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2010
Last updated Oct 29th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215255633 NPPES
Texas MEDICAID 337030602
Texas MEDICAID 2103610

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