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Individual
TERESA ANN CRUTCHLEY
Active
Individual
TERESA ANN CRUTCHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2006-00871
NC
2086S0129X
Vascular Surgery Physician
MD2003-0671
NM
2086S0129X
Vascular Surgery Physician
Primary
N2045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201160305
—
TX
01
—
8DC256
BCBSTX
TX
Enumeration date
08/08/2006
Last updated
06/15/2012
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