Provider Demographics
NPI:1710938022
Name:CROWNOVER, ROY MICHAEL JR (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:MICHAEL
Last Name:CROWNOVER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 HILLTOP RDG
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-2289
Mailing Address - Country:US
Mailing Address - Phone:830-964-3274
Mailing Address - Fax:
Practice Address - Street 1:600 N UNION AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4194
Practice Address - Country:US
Practice Address - Phone:830-643-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4014207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181370106Medicaid
TX8V2234OtherBCBS
TX181370102Medicaid
TX181370105Medicaid
TX8K0532OtherBCBS
TX181370101Medicaid
TX181370109Medicaid
TX8M6796OtherBCBS
TX8X7467OtherBCBS
TX8W0380OtherBCBS
TX8K0532OtherBCBS
TX181370109Medicaid
TX181370105Medicaid
TX8G6375Medicare PIN
TX8G9601Medicare PIN
TXI40587Medicare UPIN
TX8G9602Medicare PIN
TX8V2234OtherBCBS