Healthcare Provider Details

I. General information

NPI: 1215560164
Provider Name (Legal Business Name): ELIZABETH ANNE CROW PHARMD, RPH, BCGP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 05/31/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL CENTER ROAD
FORT CAVAZOS TX
76544-5060
US

IV. Provider business mailing address

590 MEDICAL CENTER RD
FORT CAVAZOS TX
76544
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8800
  • Fax:
Mailing address:
  • Phone: 254-288-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number58963
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58963
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: