Healthcare Provider Details

I. General information

NPI: 1124000831
Provider Name (Legal Business Name): THOMAS F KRAUEL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 THOMASON LN
ALTURAS CA
96101-3150
US

IV. Provider business mailing address

2640 BIEHN ST STE 3
KLAMATH FALLS OR
97601-1181
US

V. Phone/Fax

Practice location:
  • Phone: 530-233-2020
  • Fax: 530-233-5430
Mailing address:
  • Phone: 541-883-3688
  • Fax: 541-883-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT 7507 TPG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: