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General NPI Number Information
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NPI Number | 1679978266
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Entity Type | Organization
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Legal Business Name | CRAIG S ROCK MD PA
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Dates
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Enumeration Date | 10/26/2014
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 6624 FANNIN ST STE 2590
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City | HOUSTON
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State | TX
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Zip | 77030-2337
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Country | US
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Telephone | 713-799-8330
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Fax | 713-583-0953
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Provider Business Mailing Address
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Address Line | 6624 FANNIN ST STE 2590
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City | HOUSTON
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State | TX
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Zip | 77030-2337
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Country | US
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Telephone | 713-799-8330
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Fax | 713-583-0953
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRAIG ROCK
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Credential | M.D.
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Telephone | 713-799-8330
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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 | J4995
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License Number State | TX
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