Healthcare Provider Details

I. General information

NPI: 1497797237
Provider Name (Legal Business Name): STANLEY C CRAWFORD CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/28/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9742 FM 2625 E
MARSHALL TX
75672-4099
US

IV. Provider business mailing address

9742 FM 2625 E
MARSHALL TX
75672-4099
US

V. Phone/Fax

Practice location:
  • Phone: 903-472-0023
  • Fax:
Mailing address:
  • Phone: 903-472-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number237594 NA
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: