Kruczek, Kenneth Edward

Kruczek, Kenneth Edward is an individual health care provider with primary practice located at 3506 21St St Suite 605, Lubbock TX 79410-1212. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kruczek, Kenneth Edward can be contacted via phone (806) 725-4130.

Contact Information

Primary practice address
3506 21St St Suite 605 Lubbock TX 79410-1212
Phone: (806) 725-4130
Fax: (806) 723-7137
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X E6120 Texas

Profile Details

NPI number 1306849419
LBN Legal business name Kruczek, Kenneth Edward
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Oct 17th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306849419 NPPES
Texas MEDICAID 034876502
Texas MEDICAID 000Q2634
Texas Other 8CT089

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