Provider Demographics
NPI:1568059475
Name:CHAPMAN, CRAIG MATTHEW (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:MATTHEW
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147
Mailing Address - Country:US
Mailing Address - Phone:903-887-3711
Mailing Address - Fax:903-887-6674
Practice Address - Street 1:207 N 3RD STREET
Practice Address - Street 2:
Practice Address - City:MABANK
Practice Address - State:TX
Practice Address - Zip Code:75147
Practice Address - Country:US
Practice Address - Phone:903-887-3711
Practice Address - Fax:903-887-6674
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-26
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist