Provider Demographics
NPI:1790803484
Name:KRUPKA, JOSEPH PATRICK JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:KRUPKA
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9318 LOUETTA RD STE 400
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6545
Mailing Address - Country:US
Mailing Address - Phone:281-320-2700
Mailing Address - Fax:281-320-2944
Practice Address - Street 1:9318 LOUETTA RD STE 400
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6545
Practice Address - Country:US
Practice Address - Phone:281-320-2700
Practice Address - Fax:281-320-2944
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8758111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU85201Medicare UPIN
TX609542Medicare ID - Type Unspecified