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General NPI Number Information
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NPI Number | 1528047875
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Entity Type | Individual
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Provider Name | DOUGLAS CROMACK M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/14/2006
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 4801 ALBERTA AVE
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City | EL PASO
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State | TX
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Zip | 79905-2707
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Country | US
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Telephone | 915-215-5400
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Fax | 915-215-8632
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Provider Business Mailing Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 210-450-9000
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | J9650
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | J9650
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | J9650
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | J9650
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | J9650
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | J9650
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License Number State | TX
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