Provider Demographics
NPI:1033114533
Name:KREBS, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KREBS
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:PO BOX 4309
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4309
Mailing Address - Country:US
Mailing Address - Phone:281-531-5200
Mailing Address - Fax:
Practice Address - Street 1:5202 REDSTART ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-3129
Practice Address - Country:US
Practice Address - Phone:281-531-5200
Practice Address - Fax:281-531-5430
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1099208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1315848-06Medicaid
TXF50QMedicare ID - Type Unspecified
TX1315848-06Medicaid