MEDICARE: BRUCE SAMUEL KROEKER DPM

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	3171	TX
2	213E00000X	Podiatrist	3171	TX

General Provider Information

NPI Number	:	1740849140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE SAMUEL KROEKER DPM

Provider Business Mailing Address
First Line	:	2616 FM 2920 RD STE N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3590
Country	:	US
Telephone Number	:	281-444-6300
Fax Number	:	832-375-1247

Provider Business Practice Location Address
First Line	:	2616 FM 2920 RD STE N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3590
Country	:	US
Telephone Number	:	281-444-6300
Fax Number	:	832-375-1247

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	03/28/2025

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