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NPI Code Detail

MEDICARE: DOUGLAS M CROSBY

MEDICARE: DOUGLAS M CROSBY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse904845TX

General Provider Information

NPI Number : 1477063246
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS M CROSBY
Provider Business Mailing Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-472-4357
Fax Number :
Provider Business Practice Location Address
First Line : 6600 E BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78741-7537
Country : US
Telephone Number : 512-472-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2017
Last Update Date : 10/06/2017

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Directions to “ DOUGLAS M CROSBY ” Practice Location

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