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General NPI Number Information
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NPI Number | 1013953959
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Entity Type | Organization
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Legal Business Name | JOHN P DZIK DO PA
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 11/27/2011
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Provider Practice Location Address
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Address Line | 8745 PLANTATION DR
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City | CANYON
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State | TX
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Zip | 79015-6042
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Country | US
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Telephone | 806-622-2725
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Fax | 806-352-4887
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Provider Business Mailing Address
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Address Line | PO BOX 7391
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City | AMARILLO
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State | TX
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Zip | 79114-7391
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Country | US
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Telephone | 806-622-2725
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Fax | 806-352-4887
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN P DZIK
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Credential | DO
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Telephone | 806-622-2725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H7011
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License Number State | TX
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