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General NPI Number Information
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NPI Number | 1619142072
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Entity Type | Organization
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Legal Business Name | GEORGE F. MORICZ, M.D., P.A.
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 1002 TEXAS BLVD STE 301
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City | TEXARKANA
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State | TX
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Zip | 75501-5118
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Country | US
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Telephone | 903-794-6962
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Fax | 903-794-7139
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Provider Business Mailing Address
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Address Line | 1002 TEXAS BLVD STE 301
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City | TEXARKANA
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State | TX
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Zip | 75501-5118
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Country | US
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Telephone | 903-794-6962
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Fax | 903-794-7139
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE F. MORICZ
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Credential | M.D.
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Telephone | 903-794-6962
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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 | L2483
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License Number State | TX
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