DR. KENNETH JAMES RATAJCZAK M.D. NPI 1063418929

NPI Information

NPI: 1063418929
Provider Name: DR. KENNETH JAMES RATAJCZAK, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
3724 GREENLEAF DRIVE
WACO, TX
ZIP 76710
Phone: (254) 776-4804
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DR. Kenneth James Ratajczak, M.D. is a general practice in Waco, TX. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Kenneth James Ratajczak, M.D. NPI is 1063418929. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3724 GREENLEAF DRIVE
WACO, TX
ZIP 76710-414
Phone: (254) 776-4804

The enumeration date for this NPI number is 6/24/2005 and was last updated on 8/1/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	H1651	TEXAS	No
2	208D00000X	General Practice		H1561	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C54092	MEDICARE UPIN	TEXAS
2	5698031	OTHER	TEXAS	AETNA PROVIDER NUMBER
3	8K6251	OTHER	TEXAS	BCBS PROVIDER NUMBER
4	8B6767	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	MEDICARE PROVIDER NUMBER
5	P00124090	OTHER	TENNESSEE	RAILROAD MEDICARE PROV NO
6	134236208	MEDICAID	TEXAS
7	8G9179	MEDICARE PIN	TEXAS
8	134236209	MEDICAID	TEXAS
9	P00348744	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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