Individual
DR. GEORGE KOSTOHRYZ II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4625 BOAT CLUB RD, SUITE 257, FORT WORTH, TX 76135-7022
(817) 346-6464
(817) 238-0054
Mailing address
4625 BOAT CLUB RD, SUITE 257, FORT WORTH, TX 76135-7022
(817) 346-6464
(817) 238-2358
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
E8642
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120230103
—
TX
Enumeration date
02/13/2006
Last updated
12/01/2010
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