Provider Demographics
NPI:1184613341
Name:PRINGLE, TIMOTHY CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:CRAIG
Last Name:PRINGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4541 N JOSEY LN STE 140
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4662
Mailing Address - Country:US
Mailing Address - Phone:972-906-1055
Mailing Address - Fax:972-956-0815
Practice Address - Street 1:4541 N JOSEY LN STE 140
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4662
Practice Address - Country:US
Practice Address - Phone:972-906-1055
Practice Address - Fax:972-956-0815
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350749622086S0129X
TXM82622086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196274801Medicaid
TX8F8102Medicare PIN