=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306962246
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUCZEK KOBZA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 VISION PARK BLVD
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77384-3012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-363-2829
-----------------------------------------------------
Fax | 281-292-2145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 VISION PARK BLVD
-----------------------------------------------------
City | SHENANDOAH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77384-3012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-363-2829
-----------------------------------------------------
Fax | 281-292-1201
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER, BUCZEK & KOBZA, PLLC
-----------------------------------------------------
Name | DR. RONALD ALAN BUCZEK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-363-2829
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2082S0105X
-----------------------------------------------------
Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
-----------------------------------------------------
License Number | K9742
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207XS0106X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Hand Surgery Physician
-----------------------------------------------------
License Number | L4499
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------