Provider Demographics
NPI:1962723791
Name:CRAWFORD, WILLIAM S (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 ALTAMESA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-5475
Mailing Address - Country:US
Mailing Address - Phone:817-854-9969
Mailing Address - Fax:817-845-9965
Practice Address - Street 1:5900 ALTAMESA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-5475
Practice Address - Country:US
Practice Address - Phone:817-854-9969
Practice Address - Fax:817-845-9965
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122526207X00000X
TXP7418207X00000X, 207XX0004X
TXBP10037392390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX362519601Medicaid
FLIG947ZMedicare PIN
TX362519601Medicaid