Provider Demographics
NPI:1821461831
Name:CROWHURST, GEORGIA (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:
Last Name:CROWHURST
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11715 GOLDSTREAM CT
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8148
Mailing Address - Country:US
Mailing Address - Phone:281-216-5441
Mailing Address - Fax:
Practice Address - Street 1:11715 GOLDSTREAM CT
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8148
Practice Address - Country:US
Practice Address - Phone:281-216-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102-18012174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN