1316957525 NPI number — DEBRA KRIEG, MD PA

Table of content: (NPI 1316957525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316957525 NPI number — DEBRA KRIEG, MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEBRA KRIEG, MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316957525
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10840 TEXAS HEALTH TRAIL
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76244-6850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-491-0223
Provider Business Mailing Address Fax Number:
817-491-0238

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4100 HERITAGE TRACE PKWY
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
KELLER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76248-1306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-491-0223
Provider Business Practice Location Address Fax Number:
817-491-0238
Provider Enumeration Date:
08/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KRIEG
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
PEARL
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
817-491-0223

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L6090 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com