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General NPI Number Information
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NPI Number | 1972727691
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Entity Type | Organization
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Legal Business Name | PHILLIP R CRAVEN JR., M.D., P.A.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 9150 HUEBNER RD SUITE 390
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1558
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Country | US
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Telephone | 210-561-7200
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Fax | 210-561-7199
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Provider Business Mailing Address
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Address Line | 9150 HUEBNER RD SUITE 390
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1558
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Country | US
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Telephone | 210-561-7200
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Fax | 210-561-7199
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. PHILLIP R CRAVEN JR.
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Credential | MD
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Telephone | 210-561-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D9406
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License Number State | TX
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