Provider Demographics
NPI:1780946301
Name:KBBR INC.
Entity type:Organization
Organization Name:KBBR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:NWABOH
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:281-531-0661
Mailing Address - Street 1:14526 OLD KATY RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1021
Mailing Address - Country:US
Mailing Address - Phone:281-531-0661
Mailing Address - Fax:
Practice Address - Street 1:14526 OLD KATY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1021
Practice Address - Country:US
Practice Address - Phone:281-531-0661
Practice Address - Fax:281-531-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX696808261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care