Provider Demographics
NPI:1316560709
Name:CRUTSINGER, COLLIN PHILLIP (MD)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:PHILLIP
Last Name:CRUTSINGER
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 1:301 UNIVERSITY BLVD, 5.504 JENNIE SEALY HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0877
Mailing Address - Country:US
Mailing Address - Phone:409-266-7811
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD, 5.504 JENNIE SEALY HOSPITAL
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0877
Practice Address - Country:US
Practice Address - Phone:409-266-7811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10070756207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology