Provider Demographics
NPI:1104642511
Name:DOC MCCRACKIN, PLLC
Entity type:Organization
Organization Name:DOC MCCRACKIN, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRIMARY PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MCCRACKIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:281-323-0092
Mailing Address - Street 1:8714 SPRING CYPRESS RD STE 170
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8714 SPRING CYPRESS RD STE 170
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3396
Practice Address - Country:US
Practice Address - Phone:346-808-7084
Practice Address - Fax:346-740-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care