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Individual

JEROME R CRANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
707 N WALDRIP ST, GRAND SALINE, TX 75140-1555
(903) 962-4242
(903) 962-7799
Mailing address
707 N WALDRIP ST, GRAND SALINE, TX 75140-1555
(903) 913-6300

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01073
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1A3305
MEDICARE
TX
05
307729903
TX
01
8561ND
BCBS
TX
01
8MD176
BCBS
TX
01
909591
MEDICARE
TX
Enumeration date
03/01/2007
Last updated
12/16/2022
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