Crumpler, Charles Prentice

Crumpler, Charles Prentice is an individual health care provider with primary practice located at 709 Hollybrook Dr Suite 2301, Longview TX 75605-2411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Crumpler, Charles Prentice can be contacted via phone (903) 757-5804.

Contact Information

Primary practice address
709 Hollybrook Dr Suite 2301 Longview TX 75605-2411
Phone: (903) 757-5804
Fax: (903) 232-2889
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X E6296 Texas

Profile Details

NPI number 1609986165
LBN Legal business name Crumpler, Charles Prentice
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Nov 9th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609986165 NPPES
Texas MEDICAID 126482208
Texas Other 83X183

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