Provider Demographics
NPI:1336147511
Name:KRUPP, MYRON I (DPM)
Entity type:Individual
Prefix:
First Name:MYRON
Middle Name:I
Last Name:KRUPP
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 1:7208 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8693
Mailing Address - Country:US
Mailing Address - Phone:817-284-8271
Mailing Address - Fax:817-284-2940
Practice Address - Street 1:7208 GLENVIEW DR
Practice Address - Street 2:
Practice Address - City:RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8693
Practice Address - Country:US
Practice Address - Phone:817-284-8271
Practice Address - Fax:817-284-2940
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX0332213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT14279Medicare UPIN