Individual
CRAIG THOMAS DE WAAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 W 38TH ST, AUSTIN, TX 78705-1006
(512) 324-1000
Mailing address
6300 LA CALMA DR, SUITE 200, AUSTIN, TX 78752-3843
(512) 452-8533
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M5683
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184866501
—
TX
05
—
184866502
—
TX
01
—
184866503
CSHCN
TX
05
—
184866504
—
TX
01
—
184866505
CSHCN
TX
05
—
184866506
—
TX
05
—
184866507
—
TX
01
—
8K8349
BCBS
TX
01
—
8S1819
BCBS
TX
01
—
8V5765
BCBS
TX
01
—
8W9493
BCBS
TX
01
—
8X7452
BCBS
TX
Enumeration date
10/06/2006
Last updated
12/19/2008
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