Individual
MR. CODY LAWRENCE CRISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
605 E SAN ANTONIO ST STE 430E, VICTORIA, TX 77901-6007
(361) 576-0011
Mailing address
501 BLYTH RD, VICTORIA, TX 77904-2823
(361) 208-5781
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1030954
TX
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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