MEDICARE: DR. CRAIG D WHITING DO

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	207Q00000X	Family Medicine Physician	F4681	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	131742100	OTHER	TX	FIRSTCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	83163	OTHER	TX	SCOTT & WHITE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8F9835	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1942282520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG D WHITING DO

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-2628
Country	:	US
Telephone Number	:	254-215-9704
Fax Number	:	325-248-2108

Provider Business Practice Location Address
First Line	:	2005 W WALLACE ST
Second Line	:
City	:	SAN SABA
State	:	TX
Zip	:	76877-3928
Country	:	US
Telephone Number	:	325-372-5773
Fax Number	:	325-372-3988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	01/25/2022

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