Healthcare Provider Details

I. General information

NPI: 1831535459
Provider Name (Legal Business Name): CRAIG FIELD PHD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 PALO ALTO WAY
AUSTIN TX
78732-2453
US

IV. Provider business mailing address

325 PALO ALTO WAY
AUSTIN TX
78732-2453
US

V. Phone/Fax

Practice location:
  • Phone: 512-968-5880
  • Fax:
Mailing address:
  • Phone: 512-968-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number31272
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: