Organization
CHARLES J. LOSTAK, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JOHN LOSTAK D.O. (PRESIDENT)
(214) 948-8856
Entity
Organization
Contact information
Practice address
221 W COLORADO BLVD, PAVILION II, SUITE 940, DALLAS, TX 75208-2363
(214) 948-8856
(214) 948-5516
Mailing address
221 W COLORADO BLVD, PAVILION II, SUITE 940, DALLAS, TX 75208-2363
(214) 948-8856
(214) 948-5516
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
H0576
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477549913
NPI INDIV. PROVIDER
TX
Enumeration date
07/16/2006
Last updated
08/22/2020
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