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General NPI Number Information
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NPI Number | 1013960921
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Entity Type | Individual
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Provider Name | KEVIN J. BOZIC MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 1301 W 38TH ST STE 102
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City | AUSTIN
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State | TX
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Zip | 78705-1000
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Country | US
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Telephone | 512-454-4561
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Fax | 512-406-7330
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Provider Business Mailing Address
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Address Line | 1400 BARBARA JORDAN BLVD DEPT OF SURGERY AND PERIOPERATIVE CARE - STE. 1.114 AC
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City | AUSTIN
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State | TX
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Zip | 78723-3092
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Country | US
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Telephone | 512-495-5089
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Fax | 512-324-8906
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A81571
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | Q3646
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License Number State | TX
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