Healthcare Provider Details

I. General information

NPI: 1073804688
Provider Name (Legal Business Name): CRAIG WALTER COLLIER CRT, RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER ST
SAN ANTONIO TX
78229-4404
US

IV. Provider business mailing address

9351 ASPEN OAK
SAN ANTONIO TX
78254-5313
US

V. Phone/Fax

Practice location:
  • Phone: 210-617-5300
  • Fax:
Mailing address:
  • Phone: 210-563-0137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number61620
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: