Provider Demographics
NPI:1508501099
Name:CRAIN, ALYSSA KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KATHLEEN
Last Name:CRAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 ELMORA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3711
Mailing Address - Country:US
Mailing Address - Phone:281-636-5362
Mailing Address - Fax:
Practice Address - Street 1:2200 CHILDREN'S WAY
Practice Address - Street 2:8232 DOT
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-9225
Practice Address - Country:US
Practice Address - Phone:615-936-2555
Practice Address - Fax:615-936-3601
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program