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Viachslav Bobovnikov

Thoracic Surgery (Cardiothoracic Vascular Surgery)

Allopathic & Osteopathic Physicians

6400 Fannin St, 2850, Houston, TX 77030-1521

PECOS Enrollment

This provider is enrolled in PECOS as VIACHESLAV BOBOVNIKOV.

Based on the most recent information from CMS, provider Viachslav Bobovnikov is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1639427594
Provider Type
Individual
Full Name
Bobovnikov, Viachslav
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
8/27/2012
Last Updated
7/29/2016

Contact Information

Practice Location

6400 Fannin St, 2850, Houston, TX 77030-1521

(713) 486-5100

Unlisted Fax

Mailing Location

PO Box 301173, Dallas, TX 75303-1173

(713) 500-3500

(713) 500-8630

Provider Taxonomies

Code	Description	License
Code 208G00000X Primary	Description Thoracic Surgery (Cardiothoracic Vascular Surgery) Allopathic & Osteopathic Physicians	License FTL43923 Texas

Viachslav Bobovnikov

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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