Lakeshore ENT

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

K8272 Issued in TX

Legal business name

LAKESHORE ENT

Practice address

1305 Paluxy Rd
Suite a
Granbury, TX 76048-5641

Phone

(817) 573-6673

Fax

(817) 573-9783

NPI assigned

Nov 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephen George Krzeminski, D.O., FAOCONPI 1992783393

Title

Owner

Phone

(817) 573-6673

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen George Krzeminski, D.O.

  • Facial Plastic Surgery Physician
  • Granbury, TX
  • NPI 1992783393
  Medicare reassignment Care Compare group NPD Authorized official
• Jessica Renee Tryon, FNP-C

  • Family Nurse Practitioner
  • Tolar, TX
  • NPI 1376295220
  Medicare reassignment Care Compare group NPD
• Jennifer Jo Winkle, AU.D.,CCC-A

  • Audiologist
  • Granbury, TX
  • NPI 1285885830
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1003096991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 PALUXY RD",
            "address_2": "SUITE A",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485641",
            "telephone_number": "817-573-6673",
            "fax_number": "817-573-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 PALUXY RD",
            "address_2": "SUITE A",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485641",
            "telephone_number": "817-573-6673",
            "fax_number": "817-573-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE ENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "KRZEMINSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-573-6673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O., FAOCO"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": "K8272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Granbury Dental & Orthodontics PLLC
• Lake Granbury HB Medical Services LLC
• Lake Granbury Hospital-Based Professional Services
• Lake Granbury Internal Medicine & Pediatrics, PA
• Lake Pointe Resource Center, Inc.
• Lakeside Family Care Clinic
• Lakeview Dental, LLC
• Matthew Edward Lambert, PH.D.
• Megan Ann Landress, LCDC
• Donald Henry Lane, PH.D.

• Facial Plastic Surgery Physician in Granbury, TX
• Providers in Granbury, TX by specialty
• Facial Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.