MEDICARE: PIOTR PAWEL KUKLINSKI MD

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
1	207R00000X	Internal Medicine Physician	M3284	TX
2	208M00000X	Hospitalist Physician	M3284	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700878295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIOTR PAWEL KUKLINSKI MD

Provider Business Mailing Address
First Line	:	14641 IRON HORSE WAY
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-3999
Country	:	US
Telephone Number	:	210-978-6498
Fax Number	:	210-701-8920

Provider Business Practice Location Address
First Line	:	14641 IRON HORSE WAY
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-3999
Country	:	US
Telephone Number	:	210-978-6498
Fax Number	:	210-701-8920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	09/12/2022

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