Provider Demographics
NPI:1104541200
Name:CRAWFORD, ANGELA LATRICE (PNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LATRICE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6909 BRISBANE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7145
Mailing Address - Country:US
Mailing Address - Phone:832-222-5437
Mailing Address - Fax:
Practice Address - Street 1:6909 BRISBANE CT STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7146
Practice Address - Country:US
Practice Address - Phone:832-222-5437
Practice Address - Fax:832-222-5438
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110347363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics