Provider Demographics
NPI:1104098276
Name:CRAWFORD, LAKIESHA KITCHEN (MD)
Entity type:Individual
Prefix:
First Name:LAKIESHA
Middle Name:KITCHEN
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:LAKIESHA
Other - Middle Name:DINESE
Other - Last Name:KITCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2780 SW WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-8338
Mailing Address - Country:US
Mailing Address - Phone:817-378-4777
Mailing Address - Fax:817-378-4777
Practice Address - Street 1:2780 SW WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-8338
Practice Address - Country:US
Practice Address - Phone:817-378-4777
Practice Address - Fax:817-378-4777
Is Sole Proprietor?:No
Enumeration Date:2008-03-29
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8236207L00000X
TN47674208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology