Provider Demographics
NPI:1033294004
Name:TOWER MEDICAL CENTER OF NEDERLAND PA
Entity Type:Organization
Organization Name:TOWER MEDICAL CENTER OF NEDERLAND PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-724-2321
Mailing Address - Street 1:2100 HWY 365
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627
Mailing Address - Country:US
Mailing Address - Phone:409-724-2321
Mailing Address - Fax:409-729-7237
Practice Address - Street 1:2100 HWY 365
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627
Practice Address - Country:US
Practice Address - Phone:409-724-2321
Practice Address - Fax:409-729-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
183039600OtherBUREAU OF PRISONS WC
C14852Medicare UPIN