Provider Demographics
NPI:1558369801
Name:CRAWFORD-FIALLOS, AMY K (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:K
Last Name:CRAWFORD-FIALLOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:KRISTEN
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2414 TANGLEY ST BLDG B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2514
Mailing Address - Country:US
Mailing Address - Phone:713-503-9687
Mailing Address - Fax:713-668-8039
Practice Address - Street 1:2414 TANGLEY ST BLDG B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2514
Practice Address - Country:US
Practice Address - Phone:713-503-9687
Practice Address - Fax:713-668-8039
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2023-04-14
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
TX8801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2232191OtherFIRST HEALTH
TX1051703OtherAMERICAN SPECIALTY HEALTH
TX5538184OtherC C N
TX8P5620OtherBLUE CROSS BLUE SHIELD
TX167691801Medicaid
TX667633OtherA C N GROUP
TX760671946OtherINTERPLAN HEATLH GROUP
TX6028517OtherCIGNA