MEDICARE: CADEN CROW

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	183700000X	Pharmacy Technician	349823	TX

General Provider Information

NPI Number	:	1639033749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CADEN CROW

Provider Business Mailing Address
First Line	:	2551 W VILLA MARIA RD APT 313
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77807-2502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2551 W VILLA MARIA RD APT 313
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77807-2502
Country	:	US
Telephone Number	:	979-451-4436
Fax Number	:

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ CADEN CROW ” Practice Location

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