Provider Demographics
NPI:1407179351
Name:PIOTROWSKI, JONATHAN PAUL (PA)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PAUL
Last Name:PIOTROWSKI
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2201 CLEO ST STE B
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1914
Mailing Address - Country:US
Mailing Address - Phone:361-299-0125
Mailing Address - Fax:855-618-2519
Practice Address - Street 1:2201 CLEO ST STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1914
Practice Address - Country:US
Practice Address - Phone:361-299-0125
Practice Address - Fax:855-618-2519
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant