Provider Demographics
NPI:1629084124
Name:KROL, STEVEN P (PT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:P
Last Name:KROL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4252 S ALAMEDA
Mailing Address - Street 2:SUITE C
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-2446
Mailing Address - Country:US
Mailing Address - Phone:361-993-9434
Mailing Address - Fax:361-993-9437
Practice Address - Street 1:4252 S ALAMEDA
Practice Address - Street 2:SUITE C
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-2446
Practice Address - Country:US
Practice Address - Phone:361-993-9434
Practice Address - Fax:361-993-9437
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
650192Medicare ID - Type Unspecified