MEDICARE: DR. ANDRZEJ JERZY JANECKI 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	207RG0100X	Gastroenterology Physician	K3282	TX

General Provider Information

NPI Number	:	1871591263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDRZEJ JERZY JANECKI M.D.

Provider Business Mailing Address
First Line	:	1331 W GRAND PARKWAY N
Second Line	:	SUITE 350
City	:	KATY
State	:	TX
Zip	:	77493-2711
Country	:	US
Telephone Number	:	281-395-8688
Fax Number	:	281-395-8480

Provider Business Practice Location Address
First Line	:	1331 W GRAND PARKWAY N
Second Line	:	SUITE 350
City	:	KATY
State	:	TX
Zip	:	77493-2711
Country	:	US
Telephone Number	:	281-395-8688
Fax Number	:	281-395-8480

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	11/09/2007

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