Provider Demographics
NPI:1306880901
Name:NUILA CROUSE, EDWARD JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JAMES
Last Name:NUILA CROUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2050 NORTH LOOP WEST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018
Mailing Address - Country:US
Mailing Address - Phone:713-688-0720
Mailing Address - Fax:713-688-9555
Practice Address - Street 1:2050 NORTH LOOP WEST
Practice Address - Street 2:SUITE 224
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:713-688-0720
Practice Address - Fax:713-688-9555
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG4367207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCO1866Medicare UPIN
TX00TY41Medicare PIN