Provider Demographics
NPI:1184705071
Name:URBAN, CRAIG D (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:URBAN
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 1:3190 ANTILLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5015
Mailing Address - Country:US
Mailing Address - Phone:325-672-5603
Mailing Address - Fax:325-672-6570
Practice Address - Street 1:3190 ANTILLEY ROAD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5015
Practice Address - Country:US
Practice Address - Phone:325-672-5603
Practice Address - Fax:325-672-6570
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2977207N00000X, 207ND0101X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115642402Medicaid
TX125915100OtherFIRST CARE
TX8AR520OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX118569OtherSUPERIOR HEALTH PLAN
TX4650549OtherAETNA
TX88540NOtherBLUECROSS BLUESHIELD
TX070011407OtherRAILROAD MEDICARE
TX88540NMedicare PIN
TX070011407OtherRAILROAD MEDICARE
TX118569OtherSUPERIOR HEALTH PLAN