Individual
DR. KEVIN WAYE MCCRARY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2072
Mailing address
1103 MARIGOLD LN, LONGVIEW, TX 75604-2844
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K5155
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012079
TX KIDNEY HEALTH
TX
01
—
118644
CHIP PROGRAM
TX
01
—
752961826A009
CHAMPUS
TX
01
—
84711S
BLUE CROSS BLUE SHIELD TX
TX
01
—
MDK5155
WORKERS COMP
TX
01
—
P00048096
TRAVELER MEDICARE
TX
Enumeration date
04/26/2006
Last updated
07/08/2007
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