Provider Demographics
NPI:1538250402
Name:CROLEY, JAMES P JR (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:CROLEY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 W BITTERS RD
Mailing Address - Street 2:BLDG #6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216
Mailing Address - Country:US
Mailing Address - Phone:210-366-3603
Mailing Address - Fax:210-366-4652
Practice Address - Street 1:1202 W BITTERS RD
Practice Address - Street 2:BLDG #6
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216
Practice Address - Country:US
Practice Address - Phone:210-366-3603
Practice Address - Fax:210-366-4652
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice