Provider Demographics
NPI:1962825216
Name:BUCZEK, RONALD A II (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:BUCZEK
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11615 ANGUS RD STE 106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4064
Mailing Address - Country:US
Mailing Address - Phone:512-436-9986
Mailing Address - Fax:512-436-8295
Practice Address - Street 1:11615 ANGUS RD STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4064
Practice Address - Country:US
Practice Address - Phone:512-436-9986
Practice Address - Fax:512-436-8295
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3126208600000X, 208600000X
UT10197429-1204208600000X, 2086S0102X
TXBP10044527208600000X
OH34.0131862086S0102X, 2086S0105X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX407839601Medicaid
TX590258OtherMEDICARE
OH0268501Medicaid
TX590258OtherMEDICARE
OHH594490OtherMEDICARE