Provider Demographics
NPI:1306962246
Name:BUCZEK & KOBZA, PLLC
Entity type:Organization
Organization Name:BUCZEK & KOBZA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUCZEK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-363-2829
Mailing Address - Street 1:101 VISION PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3012
Mailing Address - Country:US
Mailing Address - Phone:281-363-2829
Mailing Address - Fax:281-292-1201
Practice Address - Street 1:101 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3012
Practice Address - Country:US
Practice Address - Phone:281-363-2829
Practice Address - Fax:281-292-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK97422082S0105X
TXL4499207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158920201Medicaid
TX154020501Medicaid
TXH06960Medicare UPIN
TX00615VMedicare PIN
TXH58080Medicare UPIN