MEDICARE: DR. WILLIAM J CROWLEY III D.O.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	K8099	TX
2	207Q00000X	Family Medicine Physician	K8099	TX

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

NPI Number	:	1609870161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM J CROWLEY III D.O.

Provider Business Mailing Address
First Line	:	815 N VIRGINIA ST
Second Line	:
City	:	PORT LAVACA
State	:	TX
Zip	:	77979-3025
Country	:	US
Telephone Number	:	361-552-0325
Fax Number	:	361-552-0230

Provider Business Practice Location Address
First Line	:	1016 N VIRGINIA ST
Second Line	:
City	:	PORT LAVACA
State	:	TX
Zip	:	77979-3000
Country	:	US
Telephone Number	:	361-552-0325
Fax Number	:	361-500-6904

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

Provider Enumeration Date	:	06/11/2005
Last Update Date	:	09/25/2024

LOTE 18 METRO OFFICE PARK , 3RD FLOOR SUITE 3000 AMERICAN HEALTH MEDICARE BUILDING
GUAYNABO, PR
00968

Practice Phone: 787-620-1919
Practice Fax: 787-620-0570