Provider Demographics
NPI:1881155604
Name:BRECEVICH, ANTONIO THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:THOMAS
Last Name:BRECEVICH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PRESBYTERIAN HEALTHCARE SERVICE
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:832-325-7125
Mailing Address - Fax:713-512-2200
Practice Address - Street 1:1010 SPRUCE ST 3RD FLOOR AREA 4
Practice Address - Street 2:GENERAL SURGERY
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2724
Practice Address - Country:US
Practice Address - Phone:505-367-0340
Practice Address - Fax:505-367-0346
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2025-10-13
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Provider Licenses
StateLicense IDTaxonomies
NMMD2024-1093208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery