Provider Demographics
NPI:1336769298
Name:WARNER, CRAIG MICHAEL (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MICHAEL
Last Name:WARNER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 MEADOW GUST DR
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-1375
Mailing Address - Country:US
Mailing Address - Phone:954-609-7564
Mailing Address - Fax:
Practice Address - Street 1:800 5TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7301
Practice Address - Country:US
Practice Address - Phone:817-250-7519
Practice Address - Fax:817-250-7501
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12810202251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports