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General NPI Number Information
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NPI Number | 1578751095
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Entity Type | Organization
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Legal Business Name | HEB NEUROSURGERY PA
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1604 HOSPITAL PKWY STE 501
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City | BEDFORD
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State | TX
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Zip | 76022-6932
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Country | US
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Telephone | 817-510-5000
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Fax | 817-510-5001
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Provider Business Mailing Address
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Address Line | 1604 HOSPITAL PKWY STE 501
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City | BEDFORD
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State | TX
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Zip | 76022-6932
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Country | US
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Telephone | 817-510-5000
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Fax | 817-510-5001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID E KOSMOSKI
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Credential | MD
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Telephone | 817-510-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H4471
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License Number State | TX
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