Organization
EUELL W CRISP, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUELL W CRISP MD (OWNER/DIRECTOR)
(361) 579-0315
Entity
Organization
Contact information
Practice address
501 N REYNOLDS ST, ALICE, TX 78332-4643
(361) 664-7364
Mailing address
501 N REYNOLDS ST, ALICE, TX 78332-4643
(361) 664-7364
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057MN
BLUE CROSS
TX
Enumeration date
07/16/2006
Last updated
12/20/2007
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