Provider Demographics
NPI:1124059027
Name:GEORGE, LIBBY CRENSHAW (MD)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:CRENSHAW
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KERLOCH PT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2519
Mailing Address - Country:US
Mailing Address - Phone:281-320-8376
Mailing Address - Fax:
Practice Address - Street 1:710 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3402
Practice Address - Country:US
Practice Address - Phone:281-440-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1062207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177041405OtherCSHCN
TX8U5761OtherBCBS
TX177041404Medicaid
TX177041404Medicaid
TXP00422556Medicare PIN
TX8J0635Medicare PIN