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Individual

DR. CHARLES DOUGLAS CRUMPLER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2308 E VILLA MARIA RD, SUITE 100, BRYAN, TX 77802-2549
(979) 776-0200
(979) 776-0400
Mailing address
2308 E VILLA MARIA RD, SUITE 100, BRYAN, TX 77802-2549
(979) 776-0200
(979) 776-0400

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
M0046
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1739724
TX
05
1739732
TX
01
M0046
STATE LICENSE
TX
Enumeration date
09/12/2005
Last updated
07/05/2010
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