Individual
DR. JOSEPH GERARD KACZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 N WASHINGTON AVE, ODESSA, TX 79761-5413
(432) 335-8275
(432) 334-0687
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
J4872
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000J3215
—
NM
01
—
124516902
CSHCN
TX
05
—
124516903
—
TX
05
—
124516904
—
TX
05
—
124516905
—
TX
01
—
8R1480
BLUE CROSS OF TX
TX
01
—
920005366
RAILROAD
TX
Enumeration date
06/14/2006
Last updated
07/29/2016
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