Provider Demographics
NPI:1003982422
Name:CRAINE, DANIEL ALAN (MS, PT, OCS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALAN
Last Name:CRAINE
Suffix:
Gender:M
Credentials:MS, PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 MEDICAL PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3255
Mailing Address - Country:US
Mailing Address - Phone:281-367-1912
Mailing Address - Fax:
Practice Address - Street 1:1011 MEDICAL PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3255
Practice Address - Country:US
Practice Address - Phone:281-367-1912
Practice Address - Fax:281-367-5101
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0262791174400000X
TX13172162251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ12Z31Medicare ID - Type UnspecifiedMEDICARE ID #