Provider Demographics
NPI:1417931312
Name:BARTCZAK, DAVID LEE (OPA-C, LSA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:BARTCZAK
Suffix:
Gender:M
Credentials:OPA-C, LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17774
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7774
Mailing Address - Country:US
Mailing Address - Phone:877-563-3374
Mailing Address - Fax:713-300-6331
Practice Address - Street 1:4519 RINGROSE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2918
Practice Address - Country:US
Practice Address - Phone:877-563-3374
Practice Address - Fax:713-300-6331
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-04
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3026246ZC0007X
TXSA00398246ZS0410X
871246ZS0410X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist