Provider Demographics
NPI:1245540004
Name:CRAWFORD, BRANDON LEE (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:LEE
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 W PARMER LN
Mailing Address - Street 2:STE. 2121
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4941
Mailing Address - Country:US
Mailing Address - Phone:512-258-8880
Mailing Address - Fax:512-692-9607
Practice Address - Street 1:8701 W PARMER LN
Practice Address - Street 2:STE. 2121
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4941
Practice Address - Country:US
Practice Address - Phone:512-258-8880
Practice Address - Fax:512-692-9607
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor