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:
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Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
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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