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Individual

LUIS JANCOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
815 PENNSYLVANIA AVE, SUITE 3100, FORT WORTH, TX 76104-2224
(817) 321-0387
Mailing address
816 W CANNON ST, SUITE 3100, FORT WORTH, TX 76104-3146
(817) 321-0387

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
A98598
OH
2085R0202X
Diagnostic Radiology Physician
Primary
M8736
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992414-06
TX
Enumeration date
02/13/2007
Last updated
08/15/2012
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