Provider Demographics
NPI:1073813358
Name:GREGORY P. KROEGER, MD PLLC
Entity Type:Organization
Organization Name:GREGORY P. KROEGER, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:P
Authorized Official - Last Name:KROEGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-670-4026
Mailing Address - Street 1:1210 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2933
Mailing Address - Country:US
Mailing Address - Phone:325-670-4025
Mailing Address - Fax:325-670-4029
Practice Address - Street 1:1210 N 18TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2933
Practice Address - Country:US
Practice Address - Phone:325-670-4025
Practice Address - Fax:325-670-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2970207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty