Cometa, Teresita Agustin
Cometa, Teresita Agustin is an individual health care provider with primary practice located at 5471 Dr Martin Luther King Dr , Saint Louis MO 63112-4265. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Cometa, Teresita Agustin can be contacted via phone (314) 367-5820.Contact Information
Primary practice address
5471 Dr Martin Luther King Dr
Saint Louis MO 63112-4265
Phone: (314) 367-5820
Fax: (314) 367-6326
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36120 | Missouri |
Profile Details
| NPI number | 1013918481 |
|---|---|
| LBN Legal business name | Cometa, Teresita Agustin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Oct 6th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013918481 | NPPES |
| Missouri | MEDICAID | 201200272 | |
| Missouri | MEDICAID | 201400280 |
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