Provider Demographics
NPI:1912996562
Name:CRUMPACKER, DAVID WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:CRUMPACKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5045 LORIMAR DR
Mailing Address - Street 2:SUTE 290
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5720
Mailing Address - Country:US
Mailing Address - Phone:972-400-3146
Mailing Address - Fax:972-403-1465
Practice Address - Street 1:5300 W PLANO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4851
Practice Address - Country:US
Practice Address - Phone:972-403-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ89772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0964246402Medicaid
TX00213GMedicare PIN