Provider Demographics
NPI:1659346120
Name:BUDINICH, CRAIG STEVEN (CRNA)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:STEVEN
Last Name:BUDINICH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 UNION CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3055
Mailing Address - Country:US
Mailing Address - Phone:478-960-4170
Mailing Address - Fax:
Practice Address - Street 1:4509 UNION CREEK DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-3055
Practice Address - Country:US
Practice Address - Phone:478-960-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165657367500000X
TX827117367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00239055OtherMCRB RAILROAD
GA657963795CMedicaid
GAP00239055OtherMCRB RAILROAD