Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP125131 / RN 631182 | TX |
N | 363LC1500X | Nurse Practitioner - Community Health | 631182 | TX |
NPI | 1497179758 |
---|---|
Provider Name | Patricia A Crabtrey |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2014 |
Last Update Date | 14/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
339315901 | (05) | TX |
8844NL | BCBS (01) | TX |