Individual
SUE ELLA CROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14100 NACOGDOCHES RD, STE 116, SAN ANTONIO, TX 78247-1903
(210) 653-8989
(210) 590-4608
Mailing address
14100 NACOGDOCHES RD, STE 116, SAN ANTONIO, TX 78247-1903
(210) 653-8989
(210) 590-4608
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
H2321
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00681R
BLUE CROSS BLUE SHEILD
TX
01
—
121206004
MEDICAID EPSDT
TX
05
—
121206005
—
TX
05
—
149747101
—
TX
01
—
380000649
MEDICARE RAILROAD
TX
01
—
8446N0
BLUE CROSS BLUE SHIELD
TX
01
—
8K9696
PRINCETON MEDICAL GROUP PA
TX
Enumeration date
08/07/2006
Last updated
01/30/2013
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