Correia, Kevin Mark
Correia, Kevin Mark is an sole proprietor health care provider with primary practice located at 8155 Gladys Ave , Beaumont TX 77706. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Correia, Kevin Mark can be contacted via phone (409) 860-4007.Contact Information
Primary practice address
8155 Gladys Ave
Beaumont TX 77706
Phone: (409) 860-4007
Fax: (409) 860-1762
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 31520 | Texas |
Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 31520 | Texas |
Profile Details
NPI number | 1194718650 |
---|---|
LBN Legal business name | Correia, Kevin Mark |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 30th, 2005 |
Last updated | Apr 25th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194718650 | NPPES |
Texas | Other | 0051GZ | BLUE CROSS/BLUE SHIELD |
Texas | Other | 7473360 | BLUE CROSS/BLUE SHIELD |
Texas | Other | 305188 | BLUE CROSS/BLUE SHIELD |
Texas | MEDICAID | 1507170-01 | BLUE CROSS/BLUE SHIELD |
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