Provider Demographics
NPI:1235485079
Name:DR CRABLE OB GYN PA
Entity Type:Organization
Organization Name:DR CRABLE OB GYN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUANITA
Authorized Official - Middle Name:JAMELLE
Authorized Official - Last Name:CRABLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-364-3764
Mailing Address - Street 1:8160 WALNUT HILL LN
Mailing Address - Street 2:SUITE LL 001
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4339
Mailing Address - Country:US
Mailing Address - Phone:469-364-3764
Mailing Address - Fax:469-364-3764
Practice Address - Street 1:8160 WALNUT HILL LN
Practice Address - Street 2:SUITE LL 001
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4339
Practice Address - Country:US
Practice Address - Phone:469-364-3764
Practice Address - Fax:469-364-3764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9197207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty