Healthcare Provider Details

I. General information

NPI: 1578708640
Provider Name (Legal Business Name): KRYCH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4319 JAMES CASEY ST SUITE 100
AUSTIN TX
78745-1189
US

IV. Provider business mailing address

4319 JAMES CASEY ST SUITE 100
AUSTIN TX
78745-1189
US

V. Phone/Fax

Practice location:
  • Phone: 512-288-0533
  • Fax: 512-916-8778
Mailing address:
  • Phone: 512-288-0533
  • Fax: 512-916-8778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0891
License Number StateTX

VIII. Authorized Official

Name: STEVEN M KRYCH
Title or Position: DOCTOR OF PODIATRIC MEDICINE
Credential: D.P.M.
Phone: 512-288-0533