Conviva Medical Center Management of Texas, P.a.

NPI #1770988990 in Live Oak, Texas

Provider Information

NPI Number: 1770988990
Entity Type: Organization
Organization Name: Conviva Medical Center Management of Texas, P.a.
Primary Specialty: Internal Medicine
Enumeration Date: Oct 30, 2014
Last Updated: Jun 21, 2024

Practice Location

Address: 12602 TOEPPERWEIN RD STE 100
City: Live Oak
State: Texas
ZIP Code: 78233-3204
Phone: (210) 654-0030

Authorized Official

Name: JESSICA BONETTI
Title: ASSOCIATE DIRECTOR
Phone: (786) 507-8556

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
General Practice	208D00000X
Clinic/Center - Primary Care — Primary Care	261QP2300X
Internal Medicine	207R00000X	Primary

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