Provider Demographics
NPI:1184666737
Name:NAFTALIS, RICHARD CRAIG (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CRAIG
Last Name:NAFTALIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 1158
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-820-8585
Mailing Address - Fax:214-820-8590
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 1158
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-820-8585
Practice Address - Fax:214-820-8590
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0670207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098553304Medicaid
TX168346802Medicaid
TX8BR110OtherBCBS
TX168346801Medicaid
TX098553303Medicaid
TX8P8213OtherBCBS
TX8BR110OtherBCBS
TX098553304Medicaid
TX8P8213OtherBCBS
C74574Medicare UPIN
TX8D1298Medicare PIN
TX8C7514Medicare PIN