Kostohryz, George

Kostohryz, George is an individual health care provider with primary practice located at 4625 Boat Club Rd Suite 257, Fort Worth TX 76135-7022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kostohryz, George can be contacted via phone (817) 346-6464.

Contact Information

Primary practice address
4625 Boat Club Rd Suite 257 Fort Worth TX 76135-7022
Phone: (817) 346-6464
Fax: (817) 238-0054
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X E8642 Texas

Profile Details

NPI number 1821062357
LBN Legal business name Kostohryz, George
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Dec 1st, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821062357 NPPES
Texas MEDICAID 120230103

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