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General NPI Number Information
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NPI Number | 1750482410
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Entity Type | Organization
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Legal Business Name | JOHN F. KACZMAREK, M.D., P.A.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 3611 S SONCY RD SUITE 5-B
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City | AMARILLO
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State | TX
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Zip | 79119-6480
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Country | US
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Telephone | 806-467-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 S SONCY RD SUITE 5-B
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City | AMARILLO
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State | TX
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Zip | 79119-6408
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Country | US
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Telephone | 806-467-9400
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JOHN F KACZMAREK
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Credential | MD
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Telephone | 806-467-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | E5804
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License Number State | TX
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