Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 8498 | TX |
NPI | 1548293152 |
---|---|
Provider Name | Walter K Crooks |
First Address | Humble, TX 77346-3587 |
Second Address | Humble, TX 77346-3587 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 28/03/2014 |