Active NPI
Craig S Boudreaux, DO
- Family Medicine Physician
- Conroe, TX
National Provider Identifier
1497785117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- K4639
- Practice address
- 1169 Grand Central Pkwy
Conroe, TX 77304-3185 - Phone
- (936) 525-3600
- Fax
- (936) 525-3624
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K4639 | TX | Primary |
Addresses
Primary practice location
1169 Grand Central Pkwy
Conroe, TX 77304-3185
Mailing address
1169 Grand Central Pkwy
Conroe, TX 77304-3185
Phone (936) 525-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8K5426 | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of North Texas HSC, College of Osteopathic Med, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1169 Grand Central Pkwy
Conroe, TX 77304-3185
Phone (936) 525-3600
Hospital & facility affiliations
- Memorial Hermann Hospital System
- HCA Houston Healthcare Conroe
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sam Houston State University | Family Medicine | Current | Accepting new patients |
| Sam Houston State University | Past | Accepting new patients |
Locations
690 S Loop 336 W
Ste 200
Conroe, TX 77304
Phone (832) 262-0435
1169 Grand Central Pkwy
Conroe, TX 77304
Phone (936) 525-3600
Interoperability endpoints
- craig.boudreaux.1@20228.direct.athenahealth.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Conroe, TX
- NPI 1942850565
Family Medicine
-
- Clinical Medical Laboratory
- Huntsville, TX
- NPI 1215519368
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Conroe, TX
- NPI 1962455816
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1497785117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1169 GRAND CENTRAL PKWY",
"city": "CONROE",
"state": "TX",
"postal_code": "773043185",
"telephone_number": "936-525-3600",
"fax_number": "936-525-3624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1169 GRAND CENTRAL PKWY",
"city": "CONROE",
"state": "TX",
"postal_code": "773043185",
"telephone_number": "936-525-3600",
"fax_number": "936-525-3624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAUX",
"first_name": "CRAIG",
"middle_name": "S",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "K4639",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8K5426",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.