MEDICARE: GPK SURGICAL, PLLC

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	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1134424971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GPK SURGICAL, PLLC

Provider Business Mailing Address
First Line	:	13718 BRIGHTON PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-4434
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13718 BRIGHTON PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-4434
Country	:	US
Telephone Number	:	713-660-1710
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GRZEGOR KURZYDLO
Credential	:
Telephone Number	:	713-532-7311

Provider Enumeration Date	:	01/25/2011
Last Update Date	:	01/25/2011

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