Provider Demographics
NPI:1790339018
Name:WHITAKER, CRAIG R (PHARMD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:R
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 BUSINESS CENTER DR APT 1028
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2498
Mailing Address - Country:US
Mailing Address - Phone:832-335-1353
Mailing Address - Fax:
Practice Address - Street 1:3822 OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1340
Practice Address - Country:US
Practice Address - Phone:713-741-7323
Practice Address - Fax:713-741-3166
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist