Provider Demographics
NPI:1336375740
Name:FREEMAN, HOWARD ULYSSES JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:ULYSSES
Last Name:FREEMAN
Suffix:JR
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 1:9415 CROSS PLAINS CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2797
Mailing Address - Country:US
Mailing Address - Phone:903-391-6767
Mailing Address - Fax:
Practice Address - Street 1:9415 CROSS PLAINS CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2797
Practice Address - Country:US
Practice Address - Phone:903-391-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX720718367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206098006Medicaid
TX206098006Medicaid