MEDICARE: CRAIG A BOLTON MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1083742670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG A BOLTON MD PA

Provider Business Mailing Address
First Line	:	10670 N CENTRAL EXPY
Second Line	:	SUITE 170
City	:	DALLAS
State	:	TX
Zip	:	75231-2111
Country	:	US
Telephone Number	:	214-368-0000
Fax Number	:	214-368-1884

Provider Business Practice Location Address
First Line	:	10670 N CENTRAL EXPY
Second Line	:	SUITE 170
City	:	DALLAS
State	:	TX
Zip	:	75231-2111
Country	:	US
Telephone Number	:	214-368-0000
Fax Number	:	214-368-1884

Authorized Official
Title or Position	:	MD OWNER
Name	:	CRAIG A BOTLON
Credential	:	MD
Telephone Number	:	214-368-0000

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/22/2020

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Directions to “CRAIG A BOLTON MD PA ” Practice Location

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