Provider Demographics
NPI:1831100643
Name:KRUGER, DAVID BRUCE (PHD, PSYCHOLOGY)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:KRUGER
Suffix:
Gender:M
Credentials:PHD, PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5450 BEE CAVE RD
Mailing Address - Street 2:SUITE 5-B
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5244
Mailing Address - Country:US
Mailing Address - Phone:512-327-4827
Mailing Address - Fax:512-327-2026
Practice Address - Street 1:5450 BEE CAVE RD
Practice Address - Street 2:SUITE 5-B
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5244
Practice Address - Country:US
Practice Address - Phone:512-327-4827
Practice Address - Fax:512-327-2026
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1247103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159720OtherVALUE OPTIONS
TXSD-16OtherBC/BS
TX0004643499OtherAETNA-PIN
TX100030092001OtherAPS HEALTHCARE
TX10654329716OtherHUMANA
TXKRUGERDAOtherCORPHEALTH