Provider Demographics
NPI:1245442870
Name:CRAIG, KARINA PEACOCK (LSA, CSA)
Entity type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:PEACOCK
Last Name:CRAIG
Suffix:
Gender:M
Credentials:LSA, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27002 SKIERS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-8088
Mailing Address - Country:US
Mailing Address - Phone:713-775-9264
Mailing Address - Fax:
Practice Address - Street 1:27002 SKIERS CROSSING DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-8088
Practice Address - Country:US
Practice Address - Phone:713-775-9264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03219363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical