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NPI Code Detail

MEDICARE: MATTHEW A KRUSE DC

MEDICARE: MATTHEW A KRUSE DC
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
1111N00000XChiropractor15091TX

General Provider Information

NPI Number : 1699403436
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW A KRUSE DC
Provider Business Mailing Address
First Line : 17754 PRESTON RD STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75252-5638
Country : US
Telephone Number : 469-434-4202
Fax Number : 972-840-2435
Provider Business Practice Location Address
First Line : 17754 PRESTON RD STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75252-5638
Country : US
Telephone Number : 469-434-4202
Fax Number : 972-840-2435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2022
Last Update Date : 08/10/2022

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Directions to “ MATTHEW A KRUSE DC” Practice Location

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