Provider Demographics
NPI:1043218548
Name:CATON, KEVIN W (CRNA)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:W
Last Name:CATON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 TIMBER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-3681
Mailing Address - Country:US
Mailing Address - Phone:903-885-9097
Mailing Address - Fax:903-885-1052
Practice Address - Street 1:115 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2105
Practice Address - Country:US
Practice Address - Phone:903-885-9758
Practice Address - Fax:903-885-1052
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606119367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84989UOtherBLUE CROSS
AR99692OtherBLUE CROSS
TX8D3519Medicare ID - Type Unspecified