Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | K8735 | TX |
NPI | 1275525594 |
---|---|
Provider Name | Dr. Theresa Vogel Crouch |
First Address | Arlington, TX 76013-5249 |
Second Address | Arlington, TX 76013-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 28/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E21336 | (02) |