Provider Demographics
NPI:1952325573
Name:CRAWFORD ANDREWS & DAVIS PTR
Entity Type:Organization
Organization Name:CRAWFORD ANDREWS & DAVIS PTR
Other - Org Name:RADIOLOGY ASSOCIATES, L.L.P.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-893-3933
Mailing Address - Street 1:3560 DELAWARE ST STE 209
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-3059
Mailing Address - Country:US
Mailing Address - Phone:409-899-3684
Mailing Address - Fax:
Practice Address - Street 1:3560 DELAWARE ST STE 209
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3059
Practice Address - Country:US
Practice Address - Phone:409-899-3684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094839001Medicaid
TX00E890Medicare PIN