Individual
MR. BRIAN MARCUS KRUSTCHINSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1885
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04982
TX
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288858801
—
TX
05
—
288858802
—
TX
05
—
288858803
—
TX
Enumeration date
10/31/2005
Last updated
12/18/2023
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