Provider Demographics
NPI:1467663559
Name:CRANSTON, RAYMOND JOSEPH III (DO)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:CRANSTON
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 PORTULACA ST
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5054
Mailing Address - Country:US
Mailing Address - Phone:979-297-5968
Mailing Address - Fax:
Practice Address - Street 1:117 PORTULACA ST
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5054
Practice Address - Country:US
Practice Address - Phone:979-297-5968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3558208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice