Organization
BRAZOS VALLEY ENDOCRINOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DOULGAS CRUMPLER JR. MD (PHYSICIAN OWNER)
(979) 776-0200
Entity
Organization
Contact information
Practice address
2308 EAST VILLA MARIA, SUITE 100, BRYAN, TX 77802
(979) 776-0200
(979) 776-0400
Mailing address
2308 EAST VILLA MARIA, SUITE 100, BRYAN, TX 77802
(979) 776-0200
(979) 776-0400
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1739724
—
TX
Enumeration date
06/18/2006
Last updated
08/22/2020
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