Provider Demographics
NPI:1558423780
Name:KREIT, CAMIL I (MD)
Entity Type:Individual
Prefix:
First Name:CAMIL
Middle Name:I
Last Name:KREIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 E DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4518
Mailing Address - Country:US
Mailing Address - Phone:281-659-9533
Mailing Address - Fax:281-659-9543
Practice Address - Street 1:403 E DALLAS ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4518
Practice Address - Country:US
Practice Address - Phone:281-659-9533
Practice Address - Fax:281-659-9543
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5809207QS1201X, 2083A0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131940201Medicaid
TXE48023Medicare UPIN
TX89600JMedicare PIN