Provider Demographics
NPI:1184200248
Name:KRISBIN MEDICAL LLC
Entity Type:Organization
Organization Name:KRISBIN MEDICAL LLC
Other - Org Name:CORDIAL CARE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FNP-C, ACNPC-AG
Authorized Official - Prefix:
Authorized Official - First Name:AUGNES
Authorized Official - Middle Name:CHRISTY
Authorized Official - Last Name:BINU
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:979-267-7722
Mailing Address - Street 1:208 OAK DR S STE 501
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5789
Mailing Address - Country:US
Mailing Address - Phone:979-267-7722
Mailing Address - Fax:979-428-1199
Practice Address - Street 1:208 OAK DR S STE 501
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5789
Practice Address - Country:US
Practice Address - Phone:979-267-7722
Practice Address - Fax:979-428-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2023-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty