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General NPI Number Information
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NPI Number | 1811941040
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Entity Type | Organization
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Legal Business Name | SUSAN K CRAIG M D P A
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 3070 COLLEGE STREET SUITE 120
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City | BEAUMONT
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State | TX
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Zip | 77701-4688
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Country | US
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Telephone | 409-835-2300
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Fax | 409-835-2375
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Provider Business Mailing Address
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Address Line | 3070 COLLEGE STREET SUITE 120
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City | BEAUMONT
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State | TX
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Zip | 77701-4688
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Country | US
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Telephone | 409-835-2300
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Fax | 409-835-2375
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN K CRAIG
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Credential | M D
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Telephone | 409-835-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K2884
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License Number State | TX
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