Provider Demographics
NPI:1245568518
Name:CRAWFORD, KATHRYN CECELIA (RPH)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:CECELIA
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 PALMER HWY
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-6721
Mailing Address - Country:US
Mailing Address - Phone:409-945-0702
Mailing Address - Fax:409-945-3478
Practice Address - Street 1:3103 PALMER HWY
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-6721
Practice Address - Country:US
Practice Address - Phone:409-945-0702
Practice Address - Fax:409-945-3478
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist