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Organization

PHILLIP R CRAVEN JR., M.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PHILLIP R CRAVEN JR. MD (OWNER PHYSICIAN)
(210) 561-7200
Entity
Organization

Contact information

Practice address
9150 HUEBNER RD, SUITE 390, SAN ANTONIO, TX 78240-1558
(210) 561-7200
(210) 561-7199
Mailing address
9150 HUEBNER RD, SUITE 390, SAN ANTONIO, TX 78240-1558
(210) 561-7200
(210) 561-7199

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D9406
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110371501
TX
01
4071395
AETNA
TX
01
81631K
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
04/12/2007
Last updated
05/12/2011
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