Provider Demographics
NPI:1346555794
Name:GRZEGORZ KURZYDLO, M.D., P.A.
Entity Type:Organization
Organization Name:GRZEGORZ KURZYDLO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRZEGORZ
Authorized Official - Middle Name:PIOTR
Authorized Official - Last Name:KURZYDLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-570-4112
Mailing Address - Street 1:19411 MCKAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5713
Mailing Address - Country:US
Mailing Address - Phone:281-570-4112
Mailing Address - Fax:281-570-4067
Practice Address - Street 1:19411 MCKAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5713
Practice Address - Country:US
Practice Address - Phone:281-570-4112
Practice Address - Fax:281-570-4067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-77902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB112182Medicare PIN