KEITH ROBERT CRANDALL (NPI# 1104125780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104125780 |
| Entity Type | Individual |
| Full Name | KEITH ROBERT CRANDALL |
| Credential | DPM |
| Practice Address |
9209 Stonebank Xing Tyler TX 75703-0829 |
| Practice Telephone | 9039419247 |
| Practice Fax Number | 8885032519 |
| Mailing Telephone | 9039419247 |
| Mailing Fax Number | 8885032519 |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2014-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2066 | TX | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
BN6420119-057356 | OH | Podiatric Medicine & Surgery Service Providers |
| Street Address |
9209 STONEBANK XING |
| City | TYLER |
| State | TX |
| Zip Code | 75703-0829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538562038 | East Texas Foot and Ankle Care Pllc | Podiatrist | 9209 Stonebank Xing, Tyler, TX 75703-0829 | 2014-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992075063 | Anderson Podiatry Pllc | Podiatrist | 1407 S Fleishel Ave Ste 301, Tyler, TX 75701-3388 | 2012-01-06 |
| 1710276662 | East Texas Foot and Ankle Centers, Pa | Podiatrist | 6603 Oak Hill Blvd, Tyler, TX 75703-0586 | 2011-03-31 |
| 1689902918 | James Edward Kent | Podiatrist | 6603 Oak Hill Blvd., Tyler, TX 75703-3604 | 2009-11-24 |
| 1225137185 | East Texas Podiatry Associates, P.C. | Podiatrist | 1028 E Idel, Suite A, Tyler, TX 75701 | 2006-09-21 |
| 1285644302 | Evangela L Anderson | Podiatrist | 1407 S Fleishel Ave, Ste. 301, Tyler, TX 75701-3388 | 2006-08-09 |
| 1164468344 | Dustin Wade Smith | Podiatrist | 1761 Troup Hwy, Tyler, TX 75701-5869 | 2006-06-22 |
| 1801407887 | Greater Foundation Foot Clinics East Texas, Pllc | Podiatrist | 1761 Troup Hwy, Tyler, TX 75701-5869 | 2020-08-12 |
| 1437693330 | Kati Elizabeth Waters | Podiatrist | 6603 Oak Hill Blvd, Tyler, TX 75703-0586 | 2016-12-12 |
| 1730530924 | Sharon Overall | Podiatrist | 6603 Oak Hill Blvd, Tyler, TX 75703-0586 | 2016-06-29 |
| 1891920583 | Matthew Owen Kindle | Podiatrist | 5826 New Copeland Rd, Tyler, TX 75703-6217 | 2009-05-25 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.