Provider Demographics
NPI:1346574688
Name:CRISPIN, ANTONIO HOMERO (RADIOLGY TECH)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:HOMERO
Last Name:CRISPIN
Suffix:
Gender:M
Credentials:RADIOLGY TECH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6111 S ZARZAMORA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3202
Mailing Address - Country:US
Mailing Address - Phone:210-921-0812
Mailing Address - Fax:210-921-1006
Practice Address - Street 1:6111 S ZARZAMORA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3202
Practice Address - Country:US
Practice Address - Phone:210-921-0812
Practice Address - Fax:210-921-1006
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist