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Individual

DR. JOSEPH RICHARD KILIANSKI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 LANCASTER DR STE 101, GRAPEVINE, TX 76051-3579
(817) 251-5024
(817) 251-5135
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8450

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H4463
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041746104
TX
01
P01319803
RAILROAD MEDICARE
TX
Enumeration date
06/29/2006
Last updated
09/14/2019
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