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NPI Code Detail

MEDICARE: KEVIN PERSAD

MEDICARE: KEVIN PERSAD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist201458TX

General Provider Information

NPI Number : 1538560081
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN PERSAD
Provider Business Mailing Address
First Line : 305 N MCKINNEY ST
Second Line :
City : SWEENY
State : TX
Zip : 77480-2801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 305 N MCKINNEY ST
Second Line :
City : SWEENY
State : TX
Zip : 77480-2801
Country : US
Telephone Number : 979-548-1571
Fax Number : 979-548-3317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2014
Last Update Date : 09/15/2014

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Directions to “ KEVIN PERSAD ” Practice Location

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