Provider Demographics
NPI:1073762571
Name:ALBERT T. KOCUREK M.D., P.L.L.C.
Entity Type:Organization
Organization Name:ALBERT T. KOCUREK M.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:TERRAZAS
Authorized Official - Last Name:KOCUREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-938-5766
Mailing Address - Street 1:1125 HIGHWAY 3 N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-4048
Mailing Address - Country:US
Mailing Address - Phone:409-938-5766
Mailing Address - Fax:409-938-5589
Practice Address - Street 1:1125 HIGHWAY 3 N
Practice Address - Street 2:SUITE 100
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-4048
Practice Address - Country:US
Practice Address - Phone:409-938-5766
Practice Address - Fax:409-938-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A3596Medicare PIN