MEDICARE: DR. MARY K CROW M.D.

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
1	207RH0003X	Hematology & Oncology Physician	H7624	TX
2	207RH0003X	Hematology & Oncology Physician	MC-2469	ID

General Provider Information

NPI Number	:	1164425211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY K CROW M.D.

Provider Business Mailing Address
First Line	:	22710 PROFESSIONAL DR
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6008
Country	:	US
Telephone Number	:	281-298-8444
Fax Number	:	281-298-7720

Provider Business Practice Location Address
First Line	:	22710 PROFESSIONAL DR
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6008
Country	:	US
Telephone Number	:	281-298-8444
Fax Number	:	281-298-7720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/23/2024

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