Provider Demographics
NPI:1023014180
Name:CROWE, WILLIAM THOMAS IV (RN, FNP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:CROWE
Suffix:IV
Gender:M
Credentials:RN, FNP
Other - Prefix:
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Mailing Address - Street 1:403 N WINDING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4563
Mailing Address - Country:US
Mailing Address - Phone:214-679-1905
Mailing Address - Fax:
Practice Address - Street 1:4101 WESLEY ST
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5635
Practice Address - Country:US
Practice Address - Phone:903-454-7555
Practice Address - Fax:903-450-4420
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX561150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195616120Medicaid
TX195616120Medicaid
P82114Medicare UPIN