Active NPI
Sandra Milena Craig, PTA
- Physical Therapy Assistant
- Grand Prairie, TX
National Provider Identifier
1174004873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2137601
- Practice address
- 3055 Bardin Rd Ste 200
Grand Prairie, TX 75052 - Phone
- (972) 522-2200
- Fax
- (972) 522-2220
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2137601 | TX | Primary |
Addresses
Primary practice location
3055 Bardin Rd Ste 200
Grand Prairie, TX 75052
Mailing address
4021 Winter Springs Dr
Fort Worth, TX 76123-3410
Phone (817) 372-1076
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2137601 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1174004873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4021 WINTER SPRINGS DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761233410",
"telephone_number": "817-372-1076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 BARDIN RD STE 200",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "75052",
"telephone_number": "972-522-2200",
"fax_number": "972-522-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "SANDRA",
"middle_name": "MILENA",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-22",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2137601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.