Provider Demographics
NPI:1154483410
Name:PAUL, CRAIG HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:HAROLD
Last Name:PAUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7810 KILBRIDE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2339
Mailing Address - Country:US
Mailing Address - Phone:972-490-1138
Mailing Address - Fax:
Practice Address - Street 1:403 W CAMPBELL RD
Practice Address - Street 2:SUITE 410
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3465
Practice Address - Country:US
Practice Address - Phone:972-498-8670
Practice Address - Fax:972-498-8676
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20312Medicare UPIN