Provider Demographics
NPI:1124000831
Name:KRAUEL, THOMAS F (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:KRAUEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:2640 BIEHN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1181
Mailing Address - Country:US
Mailing Address - Phone:541-883-3688
Mailing Address - Fax:541-883-3687
Practice Address - Street 1:1201 THOMASON LN
Practice Address - Street 2:
Practice Address - City:ALTURAS
Practice Address - State:CA
Practice Address - Zip Code:96101-3150
Practice Address - Country:US
Practice Address - Phone:530-233-2020
Practice Address - Fax:530-233-5430
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 7507 TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410007471OtherPALMETTO/RAILROAD MEDICAR
CA1124000831Medicaid
CA1124000831OtherVISION SERVICE PLAN
CA12571OtherMEDICAL EYE SERVICES
CA12571OtherMEDICAL EYE SERVICES
CAAR790Medicare PIN