Provider Demographics
NPI:1003815945
Name:CRAIG EYE ASSOCIATES
Entity Type:Organization
Organization Name:CRAIG EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEITNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-657-9571
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75653-0680
Mailing Address - Country:US
Mailing Address - Phone:903-657-9571
Mailing Address - Fax:903-657-7361
Practice Address - Street 1:1600 US HIGHWAY 79 S
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654-4508
Practice Address - Country:US
Practice Address - Phone:903-657-9571
Practice Address - Fax:903-657-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4861TG152W00000X
TXE9590207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX066495503Medicaid
TX066495503Medicaid
TX00U42QMedicare PIN