Provider Demographics
NPI:1952504284
Name:CROCHET, JOHN RAY JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:RAY
Last Name:CROCHET
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 1:1015 W MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4052
Mailing Address - Country:US
Mailing Address - Phone:281-332-0073
Mailing Address - Fax:
Practice Address - Street 1:1015 W MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 2100
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4052
Practice Address - Country:US
Practice Address - Phone:281-332-0073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5676390200000X, 207VE0102X
NC2009-00417207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology