Provider Demographics
NPI:1104042795
Name:CROWDER, FELICE FAY (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICE
Middle Name:FAY
Last Name:CROWDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 N WALNUT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5312
Mailing Address - Country:US
Mailing Address - Phone:409-794-2947
Mailing Address - Fax:
Practice Address - Street 1:1040 N WALNUT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5312
Practice Address - Country:US
Practice Address - Phone:409-794-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9652207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG17078OtherUPIN NUMBER