Provider Demographics
NPI:1265496582
Name:SIEGEL, CRAIG O (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:O
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:STE 205N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:512-206-4341
Mailing Address - Fax:512-407-1947
Practice Address - Street 1:2410 ROUND ROCK AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4003
Practice Address - Country:US
Practice Address - Phone:512-341-0889
Practice Address - Fax:512-341-7147
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG8418207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E34443Medicare UPIN
2292988Medicare ID - Type Unspecified
TX8J1521Medicare PIN