Active NPI
Mark Crouch, D.O.
- Family Medicine Physician
- Hamilton, TX
National Provider Identifier
1801807565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H6139
- Practice address
- 113 E Leslie St
Hamilton, TX 76531-2209 - Phone
- (254) 386-8149
- Fax
- (254) 386-3494
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H6139 | TX | Primary |
Addresses
Primary practice location
113 E Leslie St
Hamilton, TX 76531-2209
Mailing address
113 E Leslie St
Hamilton, TX 76531-2209
Phone (254) 386-8149
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H6139 | Other | TX | TX LICENSE |
| P087G3171 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H6139 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1801807565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 E LESLIE ST",
"city": "HAMILTON",
"state": "TX",
"postal_code": "765312209",
"telephone_number": "254-386-8149",
"fax_number": "254-386-3494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 E LESLIE ST",
"city": "HAMILTON",
"state": "TX",
"postal_code": "765312209",
"telephone_number": "254-386-8149",
"fax_number": "254-386-3494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROUCH",
"first_name": "MARK",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H6139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX LICENSE",
"identifier": "H6139",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P087G3171",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.