Provider Demographics
NPI:1144201997
Name:CROWLEY, RODNEY LYNN (PT)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:LYNN
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19235 BOLTMORE BAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13857 US HIGHWAY 87 W STE 400
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-5921
Practice Address - Country:US
Practice Address - Phone:830-253-2101
Practice Address - Fax:830-779-2056
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1090199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B6956Medicare ID - Type UnspecifiedPROVIDER NUMBER