Individual
DR. EDWARD LAWRENCE MAZUCHOWSKI II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,PH.D.
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234
(210) 539-8774
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
01057843A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01057843A
IN
Other
Enumeration date
01/17/2007
Last updated
10/07/2019
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