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NPI Code Detail

MEDICARE: KARN KRITSANACHAIWANICH PA

MEDICARE: KARN KRITSANACHAIWANICH PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist17673TX

General Provider Information

NPI Number : 1326391095
Entity Type Code : Organization
Provider Name (Legal Business Name) : KARN KRITSANACHAIWANICH PA
Provider Business Mailing Address
First Line : 2312 WESTERN TRAILS BLVD
Second Line : 104-A
City : AUSTIN
State : TX
Zip : 78745-1642
Country : US
Telephone Number : 512-326-2066
Fax Number : 512-326-2955
Provider Business Practice Location Address
First Line : 2312 WESTERN TRAILS BLVD
Second Line : 104-A
City : AUSTIN
State : TX
Zip : 78745-1642
Country : US
Telephone Number : 512-326-2066
Fax Number : 512-326-2955
Authorized Official
Title or Position : OWNER
Name : DR. KARN KRITSANACHAIWANICH
Credential : DDS
Telephone Number : 512-326-2066
Provider Enumeration Date : 10/18/2012
Last Update Date : 10/18/2012

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Directions to “KARN KRITSANACHAIWANICH PA ” Practice Location

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