Individual
THEODORE W CROFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6301 HARRIS PKWY STE 300, FORT WORTH, TX 76132-4245
(817) 877-3432
(817) 346-4394
Mailing address
6301 HARRIS PKWY STE 300, FORT WORTH, TX 76132-4245
(817) 877-3432
(817) 346-4394
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
H0273
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080486601
—
TX
05
—
137134612
—
TX
01
—
80093Y
BLUE CROSS & BLUE SHIELD
TN
Enumeration date
06/09/2006
Last updated
05/27/2014
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