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General NPI Number Information
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NPI Number | 1598295925
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Entity Type | Individual
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Provider Name | CRAIG JEROME KUTZ MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-0128
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Country | US
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Telephone | 409-747-6131
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Fax |
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Provider Business Mailing Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-0128
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Country | US
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Telephone | 409-747-6131
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A158043
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | T7626
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License Number State | TX
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