1528530326 NPI number — DR. PETER GEORGE DZIEWULSKI MBBS FRCS(PLAST)

Table of content: DR. PETER GEORGE DZIEWULSKI MBBS FRCS(PLAST) (NPI 1528530326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528530326 NPI number — DR. PETER GEORGE DZIEWULSKI MBBS FRCS(PLAST)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DZIEWULSKI
Provider First Name:
PETER
Provider Middle Name:
GEORGE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBBS FRCS(PLAST)
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528530326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 650859
Provider Second Line Business Mailing Address:
DEPT 710
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75265-0859
Provider Business Mailing Address Country Code:
GB
Provider Business Mailing Address Telephone Number:
409-772-6784
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UTMB 301 UNIVERSITY BOULEVARD 6.146 JOHN SEALY ANNEX
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77555-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-772-0504
Provider Business Practice Location Address Fax Number:
409-772-5611
Provider Enumeration Date:
12/19/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  46373 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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