MEDICARE: DR. PHILIP JOSEPH STRAKA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	K9182	TX

General Provider Information

NPI Number	:	1053329573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP JOSEPH STRAKA M.D.

Provider Business Mailing Address
First Line	:	19701 KINGWOOD DR BLDG 2
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3773
Country	:	US
Telephone Number	:	281-540-8044
Fax Number	:

Provider Business Practice Location Address
First Line	:	19701 KINGWOOD DR BLDG 2
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-3773
Country	:	US
Telephone Number	:	281-540-8044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	02/06/2021

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