Provider Demographics
NPI:1104042795
Name:CROWDER, FELICE FAY (DO)
Entity type:Individual
Prefix:DR
First Name:FELICE
Middle Name:FAY
Last Name:CROWDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4804 NORTH NAVARRO STREET
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2079
Mailing Address - Country:US
Mailing Address - Phone:361-576-0330
Mailing Address - Fax:361-576-0556
Practice Address - Street 1:1040 N WALNUT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5312
Practice Address - Country:US
Practice Address - Phone:409-794-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9652208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG17078OtherUPIN NUMBER