Healthcare Provider Details

I. General information

NPI: 1306048079
Provider Name (Legal Business Name): BOZENA JANINA MROZEK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 LIBERTY PARK DR
AUSTIN TX
78746-6891
US

IV. Provider business mailing address

300 HIDDEN OAKS RD
WIMBERLEY TX
78676-6434
US

V. Phone/Fax

Practice location:
  • Phone: 512-328-3775
  • Fax:
Mailing address:
  • Phone: 512-751-1305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number181610
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: