Provider Demographics
NPI:1871591263
Name:JANECKI, ANDRZEJ JERZY (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRZEJ
Middle Name:JERZY
Last Name:JANECKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1331 W GRAND PARKWAY N
Mailing Address - Street 2:SUITE 350
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2711
Mailing Address - Country:US
Mailing Address - Phone:281-395-8688
Mailing Address - Fax:281-395-8480
Practice Address - Street 1:1331 W GRAND PARKWAY N
Practice Address - Street 2:SUITE 350
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2711
Practice Address - Country:US
Practice Address - Phone:281-395-8688
Practice Address - Fax:281-395-8480
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3282207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8179B1Medicare PIN
G71203Medicare UPIN