Provider Demographics
NPI:1316648736
Name:CROWE, RODNEY RAY
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:RAY
Last Name:CROWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23547 MARBLE PASS TRCE
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-4075
Mailing Address - Country:US
Mailing Address - Phone:281-730-3558
Mailing Address - Fax:
Practice Address - Street 1:23547 MARBLE PASS TRCE
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-4075
Practice Address - Country:US
Practice Address - Phone:281-730-3558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343800000X
TX08881234343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)