MEDICARE: TERRANEISHA CROFFITT PA-C

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	363A00000X	Physician Assistant	PA19491	TX

General Provider Information

NPI Number	:	1932608304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRANEISHA CROFFITT PA-C

Provider Business Mailing Address
First Line	:	915 GESSNER RD STE 500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2568
Country	:	US
Telephone Number	:	713-468-0303
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 GESSNER RD STE 500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2568
Country	:	US
Telephone Number	:	713-468-0303
Fax Number	:

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

Provider Enumeration Date	:	02/12/2018
Last Update Date	:	03/02/2026

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Directions to “ TERRANEISHA CROFFITT PA-C” Practice Location

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