Provider Demographics
NPI:1043244064
Name:TROY L CREAMEAN DO PA
Entity Type:Organization
Organization Name:TROY L CREAMEAN DO PA
Other - Org Name:A NEW YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CREAMEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO PA
Authorized Official - Phone:361-288-2865
Mailing Address - Street 1:5025 DEEPWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-2922
Mailing Address - Country:US
Mailing Address - Phone:361-288-2865
Mailing Address - Fax:361-888-9126
Practice Address - Street 1:5025 DEEPWOOD CIR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-2922
Practice Address - Country:US
Practice Address - Phone:361-288-2865
Practice Address - Fax:361-888-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG14036Medicare UPIN
TX00125YMedicare ID - Type Unspecified