Lee C Crocker, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00233 Issued in TX

Practice address

1807 W Slaughter LN #490
Austin, TX 78748-6208

Phone

(512) 282-8967

Fax

(512) 292-5143

NPI assigned

Jul 31, 2006

Last updated

Apr 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1255347530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26726",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787550726",
            "telephone_number": "512-407-8686",
            "fax_number": "512-421-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W SLAUGHTER LN #490",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486208",
            "telephone_number": "512-282-8967",
            "fax_number": "512-292-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "LEE",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183275002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183275001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald S Cristobal, M.D.
• Annette Crivellaro, LCSW
• Crnnurmsc,LLC
• Emily Anne Croce, PNP
• Jane Comer Crockard, PA-C
• Patrick J Crocker, D.O.
• Salena Bell Crocker, MSSW
• Margaret Ruth Crockett, NBC HWC
• Alex Nicole Croes, CAA
• Leighann Austin Croft, RN, CPNP

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.