Provider Demographics
NPI:1578714531
Name:CHAMPLIN, CRAIG A (PHD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:A
Last Name:CHAMPLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY STATION
Mailing Address - Street 2:A1100, CMA 2.200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712
Mailing Address - Country:US
Mailing Address - Phone:512-471-3841
Mailing Address - Fax:512-232-1804
Practice Address - Street 1:2504 A WHITIS
Practice Address - Street 2:CMA 2.200, A1100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712
Practice Address - Country:US
Practice Address - Phone:512-471-3841
Practice Address - Fax:512-232-1804
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50650231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist