Provider Demographics
NPI:1699386904
Name:CROW, HOUSTON COLE (PT, DPT, MBA)
Entity Type:Individual
Prefix:
First Name:HOUSTON
Middle Name:COLE
Last Name:CROW
Suffix:
Gender:M
Credentials:PT, DPT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 HAROLD DR
Mailing Address - Street 2:
Mailing Address - City:ASHDOWN
Mailing Address - State:AR
Mailing Address - Zip Code:71822-3103
Mailing Address - Country:US
Mailing Address - Phone:903-733-7245
Mailing Address - Fax:
Practice Address - Street 1:451 W LOCKE ST
Practice Address - Street 2:
Practice Address - City:ASHDOWN
Practice Address - State:AR
Practice Address - Zip Code:71822-3325
Practice Address - Country:US
Practice Address - Phone:870-898-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1332552225100000X
AR4799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist