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NPI Code Detail

MEDICARE: DEBORAH CRUMBAKER M.D.

MEDICARE: DEBORAH CRUMBAKER 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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianG9338TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457339293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH CRUMBAKER M.D.
Provider Business Mailing Address
First Line : PO BOX 163567
Second Line :
City : AUSTIN
State : TX
Zip : 78716-3567
Country : US
Telephone Number : 979-776-2400
Fax Number :
Provider Business Practice Location Address
First Line : 1604 ROCK PRAIRIE RD
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-8345
Country : US
Telephone Number : 979-776-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 07/08/2007

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