Philip H Croyle MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

E1838 Issued in TX

Legal business name

PHILIP H CROYLE MD PA

Practice address

300 Richland West Cir
Suite 2
Waco, TX 76712-7935

Phone

(254) 751-1700

Fax

(254) 751-0700

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Philip H Croyle, MD

Title

Physician

Phone

(254) 751-1700

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1275722795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23690",
            "address_2": "SUITE D",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767023690",
            "telephone_number": "254-751-1700",
            "fax_number": "254-751-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RICHLAND WEST CIR",
            "address_2": "SUITE 2",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127935",
            "telephone_number": "254-751-1700",
            "fax_number": "254-751-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP H CROYLE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "CROYLE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "254-751-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "E1838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI",
            "identifier": "159630601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159630601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AJ848",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "B22052",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LIC.",
            "identifier": "E1838",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0033QS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Waco, TX
• Providers in Waco, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.