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General NPI Number Information
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NPI Number | 1417329459
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Entity Type | Individual
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Provider Name | NATHAN CROWDER MPAS, PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/29/2015
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 9150 HUEBNER RD STE 280
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1545
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Country | US
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Telephone | 210-225-5666
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Fax | 210-561-8893
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Provider Business Mailing Address
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Address Line | 919 OAKWOOD WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10331
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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