Jackson Isaiah Crutch

Contractor · Dallas, TX

Individual Active NPI

NPI number 1962012138

Practice location

8500 N Stemmons FWY Ste 3052
Dallas, TX 75247-3969
Phone
(256) 665-1604

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NPI record

NPI
1962012138
Entity type
Individual (Type 1)
Enumeration date
August 3, 2020
Last updated
August 3, 2020
Certified
August 3, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Contractor Primary 171W00000X — —

Mailing address

1845 E Northgate Dr # 245
Irving, TX 75062-9991
Phone
(256) 665-1604

About Jackson Crutch

Jackson Isaiah Crutch is a healthcare provider registered in the NPI registry with the primary taxonomy Contractor (code 171W00000X). The practice location is 8500 N Stemmons FWY Ste 3052, Dallas, TX 75247-3969. The NPI number 1962012138 was assigned on August 3, 2020 and the record was last updated on August 3, 2020.

Frequently asked questions

What is the NPI number of Jackson Isaiah Crutch?

The NPI number is 1962012138.

What is the phone number of Jackson Crutch?

The phone number listed for the practice location is (256) 665-1604.

Where is Jackson Crutch located?

8500 N Stemmons FWY Ste 3052, Dallas, TX 75247-3969.

What is the taxonomy code for Jackson Crutch?

The primary taxonomy code is 171W00000X – Contractor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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