Provider Demographics
NPI:1649221409
Name:CRAMER, CHARLES W JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:CRAMER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:817-784-1238
Mailing Address - Fax:817-467-3083
Practice Address - Street 1:515 W MAYFIELD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2083
Practice Address - Country:US
Practice Address - Phone:817-468-2028
Practice Address - Fax:817-467-3083
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-05-16
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Provider Licenses
StateLicense IDTaxonomies
TXE2525207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131593905Medicaid
TX87T133Medicare PIN
TXC14861Medicare UPIN