Provider Demographics
NPI:1972662732
Name:DUBOIS, CRAIG R (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:R
Last Name:DUBOIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7307 CREEKBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8203
Mailing Address - Country:US
Mailing Address - Phone:512-614-3300
Mailing Address - Fax:512-614-3301
Practice Address - Street 1:7307 CREEKBLUFF DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8203
Practice Address - Country:US
Practice Address - Phone:512-416-7246
Practice Address - Fax:512-416-7246
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG58942084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB135400Medicare PIN
8L15447Medicare PIN