Healthcare Provider Details

I. General information

NPI: 1942079058
Provider Name (Legal Business Name): ALEXANDRIA CRAWFORD DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2023
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11255 HUEBNER RD STE 204
SAN ANTONIO TX
78230-1751
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax: 866-313-3397
Mailing address:
  • Phone: 800-404-6050
  • Fax: 866-313-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number14901
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: