Provider Demographics
NPI:1942461058
Name:KRYNSKI, MICHAEL GRZEGORZ (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GRZEGORZ
Last Name:KRYNSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20403 UNIVERSITY BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4978
Mailing Address - Country:US
Mailing Address - Phone:281-205-3681
Mailing Address - Fax:
Practice Address - Street 1:20403 UNIVERSITY BLVD STE 600
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4978
Practice Address - Country:US
Practice Address - Phone:281-205-3681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1863213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196942001Medicaid
TX8DE534OtherBC/BS #
TXP01090498OtherRAILROAD MEDICARE PTAN
TX196942003Medicaid
TXP00643523OtherRAILROAD MEDICARE
TXP00643523OtherRAILROAD MEDICARE
TX196942001Medicaid