Provider Demographics
NPI:1700934486
Name:HORTON, KENNETH CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:CRAIG
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1806 QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-4206
Mailing Address - Country:US
Mailing Address - Phone:806-288-7891
Mailing Address - Fax:806-288-7920
Practice Address - Street 1:1806 QUINCY ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-4206
Practice Address - Country:US
Practice Address - Phone:806-213-9533
Practice Address - Fax:806-288-7920
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG97502Medicare UPIN