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General NPI Number Information
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NPI Number | 1124318720
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Entity Type | Individual
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Provider Name | MEGAN FITCH CRADDOCK MD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2011
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 6701 FANNIN ST STE 670
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 281-682-2058
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Fax |
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Provider Business Mailing Address
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Address Line | 11511 SHADOW CREEK PKWY
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City | PEARLAND
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State | TX
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Zip | 77584-7298
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Country | US
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Telephone | 713-442-0000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | R7695
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R7695
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | R7695
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License Number State | TX
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