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NPI Code Detail

MEDICARE: KEVIN CZERWIESKI

MEDICARE: KEVIN CZERWIESKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP130138TX
2363L00000XNurse PractitionerAP130138TX

General Provider Information

NPI Number : 1386002855
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN CZERWIESKI
Provider Business Mailing Address
First Line : 7487 TORMES
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-6784
Country : US
Telephone Number : 214-316-7170
Fax Number :
Provider Business Practice Location Address
First Line : 3301 MATLOCK RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-2908
Country : US
Telephone Number : 817-465-3241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2016
Last Update Date : 04/13/2026

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Directions to “ KEVIN CZERWIESKI ” Practice Location

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