Provider Demographics
NPI:1255325015
Name:CROWE, DANIEL (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:CROWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 BROOKLYN ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4325
Mailing Address - Country:US
Mailing Address - Phone:512-660-8766
Mailing Address - Fax:
Practice Address - Street 1:2100 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4325
Practice Address - Country:US
Practice Address - Phone:512-660-8766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2623207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH239040099Medicaid
NH30003803Medicaid
NH110137019OtherRR MEDICARE
ME239040099Medicaid
MA3142426Medicaid
MARE420402Medicare PIN
MA3142426Medicaid
NH30003803Medicaid