Healthcare Provider Details

I. General information

NPI: 1164400115
Provider Name (Legal Business Name): FERENC LASZLO KOROMPAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 MICHAELS DR
TEMPLE TX
76502-3137
US

IV. Provider business mailing address

2715 MICHAELS DR
TEMPLE TX
76502-3137
US

V. Phone/Fax

Practice location:
  • Phone: 254-774-1956
  • Fax: 254-774-1940
Mailing address:
  • Phone: 254-774-1956
  • Fax: 254-774-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD 0936
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberD 0936
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberR 4660
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD.03696R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: