Provider Demographics
NPI:1376201152
Name:VOGAN, CRYSTAL R (CNA)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:R
Last Name:VOGAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 CAVALCADE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-3866
Mailing Address - Country:US
Mailing Address - Phone:281-386-4400
Mailing Address - Fax:
Practice Address - Street 1:4111 CAVALCADE ST APT 4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-3866
Practice Address - Country:US
Practice Address - Phone:281-386-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0008898861376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide