Provider Demographics
NPI:1154343382
Name:CRAWFORD, JAMES R (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 BLANCO RD
Mailing Address - Street 2:SUITE 1122
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4966
Mailing Address - Country:US
Mailing Address - Phone:210-826-2116
Mailing Address - Fax:210-525-8979
Practice Address - Street 1:7340 BLANCO RD
Practice Address - Street 2:SUITE 1122
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4966
Practice Address - Country:US
Practice Address - Phone:210-826-2116
Practice Address - Fax:210-525-8979
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21121103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX29454802Medicaid
TX8A7615Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TX29454802Medicaid