Provider Demographics
NPI:1881604437
Name:MAUD-CRAWFORD, REBECCAH (FIRST ASSIST)
Entity type:Individual
Prefix:
First Name:REBECCAH
Middle Name:
Last Name:MAUD-CRAWFORD
Suffix:
Gender:F
Credentials:FIRST ASSIST
Other - Prefix:
Other - First Name:REBECCAH
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FIRST ASSIST
Mailing Address - Street 1:1010 W 40TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4010
Mailing Address - Country:US
Mailing Address - Phone:512-459-8753
Mailing Address - Fax:512-483-6807
Practice Address - Street 1:1010 W 40TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4010
Practice Address - Country:US
Practice Address - Phone:512-459-8753
Practice Address - Fax:512-483-6807
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00063246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N4583OtherBCBS OF TEXAS