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NPI Code Detail

MEDICARE: RILEY DAVIDSON CRAWFORD

MEDICARE: RILEY DAVIDSON CRAWFORD
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
1171000000XMilitary Health Care ProviderTX

General Provider Information

NPI Number : 1710834015
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY DAVIDSON CRAWFORD
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-292-3410
Fax Number : 210-292-7868
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-292-3410
Fax Number : 210-292-7868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ RILEY DAVIDSON CRAWFORD ” Practice Location

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