Provider Demographics
NPI:1578236139
Name:CRAIG, CLAYTON KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:KYLE
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 COMMERCE ST # 717
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-4522
Mailing Address - Country:US
Mailing Address - Phone:682-325-9384
Mailing Address - Fax:
Practice Address - Street 1:701 COMMERCE ST # 717
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-4522
Practice Address - Country:US
Practice Address - Phone:682-325-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor