MEDICARE: DR. LEO M. CROWLEY M.D., M.P.H.

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	202C00000X	Independent Medical Examiner Physician	G6281	TX

General Provider Information

NPI Number	:	1699969857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEO M. CROWLEY M.D., M.P.H.

Provider Business Mailing Address
First Line	:	PO BOX 670492
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75367-0492
Country	:	US
Telephone Number	:	214-739-8675
Fax Number	:	214-368-2238

Provider Business Practice Location Address
First Line	:	5953 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5013
Country	:	US
Telephone Number	:	214-739-8675
Fax Number	:	214-368-2238

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

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	08/30/2007

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