Provider Demographics
NPI:1093824898
Name:KRUSZ, JOHN CLAUDE (PHD, MD)
Entity type:Individual
Prefix:DR
First Name:JOHN CLAUDE
Middle Name:
Last Name:KRUSZ
Suffix:
Gender:M
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5446 GLEN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4308
Mailing Address - Country:US
Mailing Address - Phone:214-750-6664
Mailing Address - Fax:214-750-6671
Practice Address - Street 1:5446 GLEN LAKES DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4308
Practice Address - Country:US
Practice Address - Phone:214-750-6664
Practice Address - Fax:214-750-6671
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG70762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB24136Medicare UPIN
TX00A60YMedicare ID - Type UnspecifiedMEDICARE NUMBER