Provider Demographics
NPI:1811424310
Name:CROW, MICHAELA ELIZABETH (ATC, LAT, BS)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ELIZABETH
Last Name:CROW
Suffix:
Gender:F
Credentials:ATC, LAT, BS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2950 OLD SPANISH TRL APT 323
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3100 CULLEN BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-6099
Practice Address - Country:US
Practice Address - Phone:713-743-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT68202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer