Individual
MICHAEL E KRUCZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10007 HUEBNER RD STE 203, SAN ANTONIO, TX 78240-1646
(210) 615-7480
(210) 614-4972
Mailing address
PO BOX 461629, SAN ANTONIO, TX 78246-1629
(210) 615-7480
(210) 614-4972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F4181
TX
207L00000X
Anesthesiology Physician
F4181
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RD41
BLUE CROSS BLUE SHIELD TX
TX
05
—
130267102
—
TX
Enumeration date
08/05/2006
Last updated
01/14/2016
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