# LAKESHORE ENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003096991
- **Authorized official:** DR. STEPHEN GEORGE KRZEMINSKI D.O., FAOCO (OWNER)
- **Authorized official phone:** (817) 573-6673

## Contact information

- **Practice address:** 1305 PALUXY RD, SUITE A, GRANBURY, TX 76048-5641
- **Practice address phone:** (817) 573-6673
- **Practice address fax:** (817) 573-9783
- **Mailing address:** 1305 PALUXY RD, SUITE A, GRANBURY, TX 76048-5641
- **Mailing address phone:** (817) 573-6673
- **Mailing address fax:** (817) 573-9783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | K8272 | TX | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 08/15/2025