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General NPI Number Information
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NPI Number | 1205887585
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Entity Type | Organization
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Legal Business Name | CRAIG STAEBEL M.D., P.A.
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 950 W UNIVERSITY AVE BUILDING 2, SUITE 207
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City | GEORGETOWN
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State | TX
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Zip | 78626-6505
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Country | US
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Telephone | 512-686-1650
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Fax | 512-686-1652
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Provider Business Mailing Address
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Address Line | 950 W UNIVERSITY AVE BUILDING 2, SUITE 207
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City | GEORGETOWN
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State | TX
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Zip | 78626-6505
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Country | US
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Telephone | 512-686-1650
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Fax | 512-686-1652
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. CRAIG ALLEN STAEBEL
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Credential | M.D.
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Telephone | 512-686-1650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | L3142
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License Number State | TX
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