Provider Demographics
NPI:1487223764
Name:CROWSEY, JACOB RYAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:RYAN
Last Name:CROWSEY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 W STATE HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4753
Mailing Address - Country:US
Mailing Address - Phone:830-626-0937
Mailing Address - Fax:
Practice Address - Street 1:1655 W STATE HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4753
Practice Address - Country:US
Practice Address - Phone:830-626-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist