Individual
DR. KENT K BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
353 N MADISON, LA GRANGE, TX 78945-2231
(979) 966-0321
(979) 968-2722
Mailing address
353 N MADISON, LA GRANGE, TX 78945-2231
(979) 966-0321
(979) 968-2722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
036116
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430064785
RR MEDICARE
TX
01
—
816414
BCBS
TX
01
—
81641U
BLUE CROSS BLUE SHIELD PI
TX
Enumeration date
10/02/2006
Last updated
09/02/2008
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