Healthcare Provider Details

I. General information

NPI: 1760480347
Provider Name (Legal Business Name): CRAIG HOWARD THOMAJAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BEE CAVE RD SUITE 202
AUSTIN TX
78746-5266
US

IV. Provider business mailing address

8135 FOREST LN # 515057
DALLAS TX
75230-2472
US

V. Phone/Fax

Practice location:
  • Phone: 512-328-8900
  • Fax: 512-328-8903
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1720
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: