Provider Demographics
NPI:1144263187
Name:KRAUS, TREVOR T (MD)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:T
Last Name:KRAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N BECKLEY AVE STE 152
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1586
Mailing Address - Country:US
Mailing Address - Phone:214-948-7700
Mailing Address - Fax:214-948-7701
Practice Address - Street 1:1411 N BECKLEY AVE STE 152
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1586
Practice Address - Country:US
Practice Address - Phone:214-948-7700
Practice Address - Fax:214-948-7701
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2682207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FE476OtherBCBS TX
TX1830853-01Medicaid
TX421179YK9HMedicare PIN
TX8FE476OtherBCBS TX
TXI63372Medicare UPIN
TX421179YK8AMedicare PIN
TX1830853-01Medicaid
TX421179YK99Medicare PIN