Provider Demographics
NPI:1285635029
Name:CHAMBERS, CRAIG A (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:A
Last Name:CHAMBERS
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 1:977 RAINTREE CIR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5022
Mailing Address - Country:US
Mailing Address - Phone:214-383-6611
Mailing Address - Fax:214-383-6614
Practice Address - Street 1:977 RAINTREE CIR
Practice Address - Street 2:SUITE 230
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5022
Practice Address - Country:US
Practice Address - Phone:214-383-6611
Practice Address - Fax:214-383-6614
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2015-02-17
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
TXK8057208100000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043240301Medicaid
TX8CR166OtherBC/BS TX - EFFECT. 02/01/2011
TXTXB117536OtherMEDICARE PART B - EFFECT. 02/01/2011
87040YOtherBCBS
TXP00913324OtherMEDICARE RAILROAD - EFFECT 02/01/2011
TXP00913324OtherMEDICARE RAILROAD - EFFECT 02/01/2011
TX6484850001Medicare NSC
TX8CR166OtherBC/BS TX - EFFECT. 02/01/2011
H15994Medicare UPIN