Provider Demographics
NPI:1447068077
Name:CROSBY, DALESHANA
Entity type:Individual
Prefix:
First Name:DALESHANA
Middle Name:
Last Name:CROSBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 QUARTZ RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1499
Mailing Address - Country:US
Mailing Address - Phone:210-799-5974
Mailing Address - Fax:
Practice Address - Street 1:3333 SOUTHFORK PKWY APT 824
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3772
Practice Address - Country:US
Practice Address - Phone:210-799-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty