Provider Demographics
NPI:1760815666
Name:CRAWFORD, SONDRA EVETTE
Entity Type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:EVETTE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-2219
Mailing Address - Country:US
Mailing Address - Phone:281-795-6614
Mailing Address - Fax:
Practice Address - Street 1:704 N THOMPSON ST
Practice Address - Street 2:SUITE 187
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2578
Practice Address - Country:US
Practice Address - Phone:281-795-6614
Practice Address - Fax:936-270-7172
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide