Provider Demographics
NPI:1306132832
Name:CRANE, BRIAN CJ (DPT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:CJ
Last Name:CRANE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 LEELAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-5133
Mailing Address - Country:US
Mailing Address - Phone:713-223-0838
Mailing Address - Fax:713-223-1310
Practice Address - Street 1:2004 LEELAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-5133
Practice Address - Country:US
Practice Address - Phone:713-223-0838
Practice Address - Fax:713-223-1310
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1206525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist