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NPI Code Detail

MEDICARE: FREDERICUS J. VAN KUIJK M.D.

MEDICARE: FREDERICUS J. VAN KUIJK 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
1207WX0107XRetina Specialist (Ophthalmology) PhysicianK8547TX
2207W00000XOphthalmology PhysicianK8547TX

General Provider Information

NPI Number : 1972699635
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICUS J. VAN KUIJK M.D.
Provider Business Mailing Address
First Line : 720 WASHINGTON AVE SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-2924
Country : US
Telephone Number : 612-884-0649
Fax Number :
Provider Business Practice Location Address
First Line : 700 UNIVERSITY BLVD
Second Line :
City : GALVESTON
State : TX
Zip : 77550-5552
Country : US
Telephone Number : 409-747-5800
Fax Number : 409-747-5825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 10/07/2025

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