Provider Demographics
NPI:1588052682
Name:BUCZEK, PRZEMYSLAW (PT)
Entity type:Individual
Prefix:
First Name:PRZEMYSLAW
Middle Name:
Last Name:BUCZEK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 WIGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5327
Mailing Address - Country:US
Mailing Address - Phone:713-726-0398
Mailing Address - Fax:
Practice Address - Street 1:5007 WIGTON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5327
Practice Address - Country:US
Practice Address - Phone:713-726-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist