Provider Demographics
NPI:1871812594
Name:CROWNE DIAGNOSTICS INC
Entity type:Organization
Organization Name:CROWNE DIAGNOSTICS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-929-6051
Mailing Address - Street 1:PO BOX 93504
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-0114
Mailing Address - Country:US
Mailing Address - Phone:817-929-6051
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ST # 93504
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7668
Practice Address - Country:US
Practice Address - Phone:817-929-6051
Practice Address - Fax:817-442-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center