Healthcare Provider Details

I. General information

NPI: 1104201110
Provider Name (Legal Business Name): CAIQIAN CROPPER MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 MADISON OAK DR SUITE 450
SAN ANTONIO TX
78258-4084
US

IV. Provider business mailing address

502 MADISON OAK DR SUITE 450
SAN ANTONIO TX
78258-4084
US

V. Phone/Fax

Practice location:
  • Phone: 210-844-5854
  • Fax:
Mailing address:
  • Phone: 210-844-5854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: