MEDICARE: DR. DAVID BRUCE KRUGER PH.D., PSYCHOLOGY

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	103TC0700X	Clinical Psychologist	2-1247	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	159720	OTHER	TX	VALUE OPTIONS
2	SD-16	OTHER	TX	BC/BS
3	0004643499	OTHER	TX	AETNA-PIN
4	100030092001	OTHER	TX	APS HEALTHCARE
5	10654329716	OTHER	TX	HUMANA
6	KRUGERDA	OTHER	TX	CORPHEALTH

General Provider Information

NPI Number	:	1831100643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BRUCE KRUGER PH.D., PSYCHOLOGY

Provider Business Mailing Address
First Line	:	5450 BEE CAVE RD
Second Line	:	SUITE 5-B
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5244
Country	:	US
Telephone Number	:	512-327-4827
Fax Number	:	512-327-2026

Provider Business Practice Location Address
First Line	:	5450 BEE CAVE RD
Second Line	:	SUITE 5-B
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5244
Country	:	US
Telephone Number	:	512-327-4827
Fax Number	:	512-327-2026

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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