Provider Demographics
NPI:1477178333
Name:CRAWFORD, MICHAEL J (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-0760
Mailing Address - Country:US
Mailing Address - Phone:903-456-1707
Mailing Address - Fax:
Practice Address - Street 1:205 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3731
Practice Address - Country:US
Practice Address - Phone:972-636-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist