Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | K9829 | TX |
NPI | 1003027335 |
---|---|
Provider Name | Zbigniew Kusmierz |
First Address | Mcallen, TX 78504-0188 |
Second Address | Edinburg, TX 78539-8466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 22/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148564102 | (05) | TX |
148564103 | (05) | TX |
H05336 | (02) |