Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | H7416 | TX |
N | 208000000X | Pediatrician | H7416 | TX |
NPI | 1588642318 |
---|---|
Provider Name | Nannette F Crow |
First Address | Fort Worth, TX 76199-0213 |
Second Address | Fort Worth, TX 76104-2733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 02/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043467204 | (05) | TX |