Provider Demographics
NPI:1194806273
Name:KRUM FAMILY HEALTHCARE ASSOCIATES
Entity type:Organization
Organization Name:KRUM FAMILY HEALTHCARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:SPROTT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:940-482-6702
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:141 W. MCCART ST
Mailing Address - City:KRUM
Mailing Address - State:TX
Mailing Address - Zip Code:76249-0608
Mailing Address - Country:US
Mailing Address - Phone:940-482-6702
Mailing Address - Fax:940-482-9704
Practice Address - Street 1:141 W. MCCART ST
Practice Address - Street 2:
Practice Address - City:KRUM
Practice Address - State:TX
Practice Address - Zip Code:76249
Practice Address - Country:US
Practice Address - Phone:940-482-6702
Practice Address - Fax:940-482-9704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2701207Q00000X
TX597377363LF0000X
TX666655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N4759OtherBCBS
TX1609973999OtherMICHELE OWENS
TX1609973999OtherMICHELE OWENS
TXQ04825Medicare UPIN
TX8B6412Medicare ID - Type UnspecifiedDANA SPROTT
TX00388WMedicare ID - Type UnspecifiedKRUM FAMILY HEALTHCARE