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NPI Code Detail

MEDICARE: DR. KEVIN F. SCHRUNK DO

MEDICARE: DR. KEVIN F. SCHRUNK DO
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
1207Q00000XFamily Medicine PhysicianP7562TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144389099
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN F. SCHRUNK DO
Provider Business Mailing Address
First Line : 6331 PROSPECT AVENUE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3938
Country : US
Telephone Number : 214-821-9161
Fax Number : 214-824-1039
Provider Business Practice Location Address
First Line : 6331 PROSPECT AVENUE
Second Line :
City : DALLAS
State : TX
Zip : 75214-3938
Country : US
Telephone Number : 214-821-9161
Fax Number : 214-824-1039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 02/17/2014

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