Basic Information
| Provider Information | |||||||||
| NPI: | 1720010903 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROW | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | CURTIS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4614 NORTH IH 35 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129789100 | ||||||||
| FaxNumber: | 5129019751 | ||||||||
| Practice Location | |||||||||
| Address1: | 4614 NORTH IH 35 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129789100 | ||||||||
| FaxNumber: | 5129019751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 04/18/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | J1512 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 149087201 | 05 | TX | MEDICAID |