Basic Information
| Provider Information | |||||||||
| NPI: | 1164582912 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEMPER | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 W 38TH ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123061323 | ||||||||
| FaxNumber: | 5123061142 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 W 38TH ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787051167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123061323 | ||||||||
| FaxNumber: | 5123061142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 01/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | K1497 | TX | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 140005922 | 01 | TX | MEDICARE RAILROAD | OTHER | 89731F | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | P089W2950 | 05 | TX | MEDICAID | 125862603 | 01 | TX | TPI | OTHER | 4562773 | 01 | TX | AETNA | OTHER |