Provider Demographics
NPI:1982006532
Name:JOSEPH HOWE CRUMBLISS, M.D., PA
Entity Type:Organization
Organization Name:JOSEPH HOWE CRUMBLISS, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:CRUMBLISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-425-5540
Mailing Address - Street 1:1680 ANTILLEY RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5267
Mailing Address - Country:US
Mailing Address - Phone:325-428-5540
Mailing Address - Fax:325-428-5545
Practice Address - Street 1:1680 ANTILLEY RD
Practice Address - Street 2:SUITE 135
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5267
Practice Address - Country:US
Practice Address - Phone:325-428-5540
Practice Address - Fax:325-428-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty