Provider Demographics
NPI:1083693097
Name:CRAYTON, STEVEN CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CARLOS
Last Name:CRAYTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1898
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75671
Mailing Address - Country:US
Mailing Address - Phone:903-938-5300
Mailing Address - Fax:903-938-5302
Practice Address - Street 1:304 UNIVERSITY AVE SUITE 108
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670
Practice Address - Country:US
Practice Address - Phone:903-938-5300
Practice Address - Fax:903-938-5302
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3871207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135017503Medicaid
TX135017503Medicaid
TX0083BFMedicare PIN