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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306849419 | NPPES |
| Texas | MEDICAID | 034876502 | |
| Texas | MEDICAID | 000Q2634 | |
| Texas | Other | 8CT089 |
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