Provider Demographics
NPI:1003834300
Name:CROSSON, KEVIN LEWIS (EMT-B)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LEWIS
Last Name:CROSSON
Suffix:
Gender:M
Credentials:EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 EL DORADO BLVD
Mailing Address - Street 2:APT. 1414
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-2284
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 FERRY RD
Practice Address - Street 2:MEDICAL
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-3185
Practice Address - Country:US
Practice Address - Phone:409-766-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other