Provider Demographics
NPI:1679978266
Name:CRAIG S ROCK MD PA
Entity type:Organization
Organization Name:CRAIG S ROCK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-799-8330
Mailing Address - Street 1:6624 FANNIN ST STE 2590
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2337
Mailing Address - Country:US
Mailing Address - Phone:713-799-8330
Mailing Address - Fax:713-583-0953
Practice Address - Street 1:6624 FANNIN ST STE 2590
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2337
Practice Address - Country:US
Practice Address - Phone:713-799-8330
Practice Address - Fax:713-583-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-26
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4995208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty