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Individual

MR. JERRY ELLIOTT KRUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1303 MCCULLOUGH AVE, SUITE #561, SAN ANTONIO, TX 78212-5668
(210) 227-9376
(210) 227-0916
Mailing address
1303 MCCULLOUGH AVE, SUITE #561, SAN ANTONIO, TX 78212-5668
(210) 227-9376
(210) 227-0916

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
E4464
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101951502
TX
Enumeration date
09/13/2006
Last updated
07/06/2010
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