Provider Demographics
NPI:1194016022
Name:M S KRAMER M D P A
Entity Type:Organization
Organization Name:M S KRAMER M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:972-484-4844
Mailing Address - Street 1:4099 MCEWEN RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5030
Mailing Address - Country:US
Mailing Address - Phone:972-484-4844
Mailing Address - Fax:972-484-0711
Practice Address - Street 1:4099 MCEWEN RD
Practice Address - Street 2:SUITE 132
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5030
Practice Address - Country:US
Practice Address - Phone:972-484-4844
Practice Address - Fax:972-484-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3526261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF3526OtherTEXAS STATE LICENSE
TXC18034Medicare UPIN