Provider Demographics
NPI:1215962733
Name:KRASKO, ANATOLI N (MD)
Entity type:Individual
Prefix:
First Name:ANATOLI
Middle Name:N
Last Name:KRASKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10837 KATY FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2207
Mailing Address - Country:US
Mailing Address - Phone:832-325-1200
Mailing Address - Fax:713-984-8260
Practice Address - Street 1:10837 KATY FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2207
Practice Address - Country:US
Practice Address - Phone:832-325-1200
Practice Address - Fax:713-984-8260
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7782207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1565Medicare PIN