Individual
GREGORY F KOZIELEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
0036-098036
IL
207W00000X
Ophthalmology Physician
K9587
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
0036-098036
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
K9587
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044052101
—
TX
05
—
044052102
—
TX
05
—
044052103
—
TX
05
—
168274001
—
AR
01
—
180043890
RR MEDICARE GRP CJ5857
TX
01
—
7909137
AETNA
TX
01
—
8583K0
BCBS/GRP 00T587
TX
Enumeration date
05/01/2006
Last updated
07/23/2024
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