Provider Demographics
NPI:1831537554
Name:CROUSE CARE CLINIC
Entity type:Organization
Organization Name:CROUSE CARE CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LAUREEN
Authorized Official - Last Name:CROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:940-294-2944
Mailing Address - Street 1:2501 W OAK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-4324
Mailing Address - Country:US
Mailing Address - Phone:940-294-2944
Mailing Address - Fax:940-239-0125
Practice Address - Street 1:2501 W OAK ST
Practice Address - Street 2:#101
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4323
Practice Address - Country:US
Practice Address - Phone:940-294-2944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care