Provider Demographics
NPI:1144308024
Name:KRENEK, DAVID OSCAR (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:OSCAR
Last Name:KRENEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3505
Mailing Address - Country:US
Mailing Address - Phone:979-245-6844
Mailing Address - Fax:979-245-0257
Practice Address - Street 1:1401 AVENUE G
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3505
Practice Address - Country:US
Practice Address - Phone:979-245-6844
Practice Address - Fax:979-245-0257
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT14266Medicare UPIN
TX601886Medicare ID - Type UnspecifiedPROVIDER #