Provider Demographics
NPI:1720237837
Name:CROWLEY SAADE CLINIC, PA
Entity Type:Organization
Organization Name:CROWLEY SAADE CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAJA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SAADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-726-2909
Mailing Address - Street 1:1005 S CROWLEY RD
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3698
Mailing Address - Country:US
Mailing Address - Phone:817-297-4455
Mailing Address - Fax:817-295-3022
Practice Address - Street 1:1005 S CROWLEY RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3698
Practice Address - Country:US
Practice Address - Phone:817-297-4455
Practice Address - Fax:817-295-3022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROWLEY SAADE CLINIC, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-12
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6614261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center