Provider Demographics
NPI:1306622022
Name:CRAIG, RONALD (RN)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:CRAIG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 BROADWAY ST STE 113
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-8923
Mailing Address - Country:US
Mailing Address - Phone:520-560-5447
Mailing Address - Fax:
Practice Address - Street 1:8201 BROADWAY ST STE 113
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8923
Practice Address - Country:US
Practice Address - Phone:520-560-5447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42013800343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)