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NPI Code Detail

MEDICARE: DAVID WAYNE KRUSLESKI M.D.

MEDICARE: DAVID WAYNE KRUSLESKI M.D.
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 PhysicianJ0052TX

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 : 1962503243
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID WAYNE KRUSLESKI M.D.
Provider Business Mailing Address
First Line : 800 W SAM HOUSTON PKWY S
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77042-1908
Country : US
Telephone Number : 713-462-6565
Fax Number : 832-831-5369
Provider Business Practice Location Address
First Line : 19333 CLAY RD
Second Line :
City : KATY
State : TX
Zip : 77449-4001
Country : US
Telephone Number : 713-462-6565
Fax Number : 281-717-4456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 05/18/2022

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Directions to “ DAVID WAYNE KRUSLESKI M.D.” Practice Location

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