Provider Demographics
NPI:1396525036
Name:CROW, BRYAN KIRK (APRN)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:KIRK
Last Name:CROW
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 DEEP WATER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-5773
Mailing Address - Country:US
Mailing Address - Phone:210-241-4058
Mailing Address - Fax:
Practice Address - Street 1:1530 DEEP WATER DR
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-5773
Practice Address - Country:US
Practice Address - Phone:210-241-4058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP156156363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care