Individual
CRAIG L DEARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 NINTH AVENUE, SUITE C, FORT WORTH, TX 76104-3906
(817) 332-3039
(817) 332-6902
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 332-6902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F3894
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110247666
RAILROAD MEDICARE
—
05
—
131705908
—
TX
Enumeration date
07/13/2006
Last updated
09/30/2011
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