Provider Demographics
NPI:1215905377
Name:KRYCH, STEVEN M (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:KRYCH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90846
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78709-0846
Mailing Address - Country:US
Mailing Address - Phone:512-288-0533
Mailing Address - Fax:512-916-8778
Practice Address - Street 1:6633 E HWY 290
Practice Address - Street 2:STE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1172
Practice Address - Country:US
Practice Address - Phone:512-288-0533
Practice Address - Fax:512-916-8778
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0891213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117510101Medicaid
TX480017010Medicare PIN
TXT14281Medicare UPIN
TX117510101Medicaid