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General NPI Number Information
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NPI Number | 1316212210
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Entity Type | Individual
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Provider Name | KRYSTAL BOWMAN AGBAHIWE CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 7200 CAMBRIDGE ST FL 10
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City | HOUSTON
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State | TX
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Zip | 77030-4202
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Country | US
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Telephone | 713-798-1750
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Fax | 713-798-4693
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Provider Business Mailing Address
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Address Line | 6720 BERTNER AVE., SUITE O-520, MC1-226 , HARRIS COUNTY ATTN: MARIE SANCHEZ
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 832-355-6279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 713027
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP121426
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License Number State | TX
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