Provider Demographics
NPI:1992786669
Name:CRAWFORD, ANDREW (CRNA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 E GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:TX
Mailing Address - Zip Code:76230-3135
Mailing Address - Country:US
Mailing Address - Phone:940-872-1126
Mailing Address - Fax:940-872-1561
Practice Address - Street 1:705 E GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:TX
Practice Address - Zip Code:76230-3135
Practice Address - Country:US
Practice Address - Phone:940-872-1126
Practice Address - Fax:940-872-1561
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX427372367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX427372Medicare UPIN
TX450497Medicare Oscar/Certification