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NPI Code Detail

MEDICARE: DR. ROBERT S CRUMB M.D.

MEDICARE: DR. ROBERT S CRUMB 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
1207V00000XObstetrics & Gynecology Physician01091937AIN
2207V00000XObstetrics & Gynecology PhysicianL6850TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2L6850OTHERTXLICENSE
301091937AOTHERINPHYSICIAN LICENSE

General Provider Information

NPI Number : 1376516732
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT S CRUMB M.D.
Provider Business Mailing Address
First Line : 823 E 38TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1809
Country : US
Telephone Number : 512-426-8173
Fax Number :
Provider Business Practice Location Address
First Line : 901 W BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78704-6903
Country : US
Telephone Number : 512-447-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 11/07/2023

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