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Organization

LAKESHORE ENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN GEORGE KRZEMINSKI D.O., FAOCO (OWNER)
(817) 573-6673
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
K8272
TX

Other

Enumeration date
11/07/2007
Last updated
08/15/2025
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