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Organization

RETINA INSTITUTE OF TEXAS PA

Active
Parent organization
RETINA INSTITUTE OF TEXAS PA
Other names
Taylor Winslow Syrquin & Kozielec, P.A.
Organization subpart
Yes

Provider details

NPI number
Legal business name
RETINA INSTITUTE OF TEXAS PA
Authorized official
DR. GREGORY F. KOZIELEC M.D. (VICE PRESIDENT)
(214) 521-1153
Entity
Organization

Contact information

Practice address
3414 OAK GROVE AVE, DALLAS, TX 75204-2375
(214) 521-1153
(214) 219-3651
Mailing address
3414 OAK GROVE AVE, DALLAS, TX 75204-2375
(214) 521-1153
(214) 219-3651

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
NA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00T587
BCBS
TX
05
085316002
TX
05
168301002
AR
05
200052590 A
OK
01
CJ5857
RR MEDICARE
TX
Enumeration date
08/30/2006
Last updated
07/23/2024
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