Healthcare Provider Details

I. General information

NPI: 1891447918
Provider Name (Legal Business Name): CARSON RAY KUZAWA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 HIGHWAY 6
SUGAR LAND TX
77478-5134
US

IV. Provider business mailing address

7311 STARFLOWER # TX77494
KATY TX
77494-0179
US

V. Phone/Fax

Practice location:
  • Phone: 713-781-4600
  • Fax:
Mailing address:
  • Phone: 832-454-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: