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NPI Code Detail

MEDICARE: CROFOOTMD CLINIC PLLC

MEDICARE: CROFOOTMD CLINIC PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0000XAdolescent Medicine (Internal Medicine) Physician
2207RA0401XAddiction Medicine (Internal Medicine) Physician
3207RG0300XGeriatric Medicine (Internal Medicine) Physician
4207RI0200XInfectious Disease Physician
52083P0901XPublic Health & General Preventive Medicine Physician
6207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1023983095
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROFOOTMD CLINIC PLLC
Provider Business Mailing Address
First Line : 3701 KIRBY DR STE 1230
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3916
Country : US
Telephone Number : 713-526-0005
Fax Number : 174-185-5802
Provider Business Practice Location Address
First Line : 3701 KIRBY DR STE 1230
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3916
Country : US
Telephone Number : 713-526-0005
Fax Number : 855-802-2503
Authorized Official
Title or Position : PRESIDENT
Name : DR. GORDON ELWOOD CROFOOT JR.
Credential : MD
Telephone Number : 713-526-0005
Provider Enumeration Date : 10/08/2025
Last Update Date : 10/08/2025

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