Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | F2977 | TX |
N | 207ND0101X | MOHS-Micrographic Surgeon | F2977 | TX |
N | 207ND0900X | Dermatopathologist | F2977 | TX |
N | 207NS0135X | Procedural Dermatology | F2977 | TX |
NPI | 1184705071 |
---|---|
Provider Name | Dr. Craig D Urban |
First Address | Abilene, TX 79606-5015 |
Second Address | Abilene, TX 79606-5015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 18/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070011407 | RAILROAD MEDICARE (01) | TX |
115642402 | (05) | TX |
118569 | SUPERIOR HEALTH PLAN (01) | TX |
125915100 | FIRST CARE (01) | TX |
4650549 | AETNA (01) | TX |
88540N | BLUECROSS BLUESHIELD (01) | TX |
8AR520 | BLUE CROSS BLUE SHIELD OF TEXAS (01) | TX |
B27191 | (02) |