Provider Demographics
NPI:1700992161
Name:KRASOWSKY, GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:KRASOWSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 S CROWLEY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3664
Mailing Address - Country:US
Mailing Address - Phone:817-297-2400
Mailing Address - Fax:
Practice Address - Street 1:1012 S CROWLEY RD
Practice Address - Street 2:SUITE B
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3664
Practice Address - Country:US
Practice Address - Phone:817-297-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
10852463OtherCAQH
MO32374Medicare ID - Type Unspecified
10852463OtherCAQH