Basic Information
| Provider Information | |||||||||
| NPI: | 1225540743 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KRIMSON MEDICAL PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2771 E BROAD ST STE 217-181 | ||||||||
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| City: | MANSFIELD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760639156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144156845 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 S CLAY ST | ||||||||
| Address2: | |||||||||
| City: | ENNIS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751195771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728758776 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2017 | ||||||||
| LastUpdateDate: | 10/25/2017 | ||||||||
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| AuthorizedOfficialLastName: | RIGSBY | ||||||||
| AuthorizedOfficialFirstName: | KEITH | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2146991096 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | M1320 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.