Kevin Credille
Student in an Organized Health Care Education/Training Program in Houston, TX. Individual provider (NPI-1).
NPI number1013662758
StatusActive
Last updated in NPPESJun 28, 2023
Details
- NPI
- 1013662758
- Entity type
- Individual (NPI-1)
- Name
- Kevin Credille
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2022
- Certification date
- Jun 28, 2023
- Last updated
- Jun 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
6565 Fannin StHouston, TX 77030-2703
Phone 414-955-8246
Mailing address
5004 Memorial Dr Apt 639Houston, TX 77007-7565
Phone 630-336-3463
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