Provider Demographics
NPI:1760480347
Name:THOMAJAN, CRAIG HOWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:HOWARD
Last Name:THOMAJAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 FOREST LN # 515057
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5266
Practice Address - Country:US
Practice Address - Phone:512-328-8900
Practice Address - Fax:512-328-8903
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1720213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1731044Medicaid
TX5388360001OtherDMERC
TX5388360001OtherDMERC
TX1731044Medicaid
TXV04412Medicare UPIN