Provider Demographics
NPI:1861943540
Name:CROWLEY, TOMMY III (HAS)
Entity type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:CROWLEY
Suffix:III
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E KALISTE SALOOM RD STE 206
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8525
Mailing Address - Country:US
Mailing Address - Phone:337-706-8550
Mailing Address - Fax:337-706-8559
Practice Address - Street 1:110 E KALISTE SALOOM RD STE 206
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8525
Practice Address - Country:US
Practice Address - Phone:337-706-8550
Practice Address - Fax:337-706-8559
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA549237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist