Provider Demographics
NPI:1205888138
Name:CRAWFORD, MATTHEW J (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 BEE CAVES RD
Mailing Address - Street 2:STE K200
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5280
Mailing Address - Country:US
Mailing Address - Phone:512-329-6644
Mailing Address - Fax:512-891-6562
Practice Address - Street 1:5656 BEE CAVES RD
Practice Address - Street 2:STE K200
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5280
Practice Address - Country:US
Practice Address - Phone:512-329-6644
Practice Address - Fax:512-891-6562
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1608207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M5472OtherBC/BS
TX181849402Medicaid
TXI57750Medicare UPIN
TX181849402Medicaid