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Organization
BRAZOS VALLEY ENDOCRINOLOGY PA
Active
Organization
BRAZOS VALLEY ENDOCRINOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DOULGAS CRUMPLER JR. MD (PHYSICIAN OWNER)
(979) 776-0200
Entity
Organization
Contact information
Practice address
2308 EAST VILLA MARIA, SUITE 100, BRYAN, TX 77802
(979) 776-0200
(979) 776-0400
Mailing address
2308 EAST VILLA MARIA, SUITE 100, BRYAN, TX 77802
(979) 776-0200
(979) 776-0400
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1739724
—
TX
Enumeration date
06/18/2006
Last updated
08/22/2020
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