Healthcare Provider Details

I. General information

NPI: 1467892091
Provider Name (Legal Business Name): JACEK PLISZCYNSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

2 GREENWAY PLZ SUITE 900
HOUSTON TX
77046-0297
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-2000
  • Fax:
Mailing address:
  • Phone: 713-798-1835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number44237
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: