CRYSTAL WELLNESS CENTER INC NPI 1124583349

NPI Information

  • NPI: 1124583349
  • Provider Name: CRYSTAL WELLNESS CENTER INC
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Organization
  • Address: 6609 BLANCO RD STE 335
    SAN ANTONIO, TX
    ZIP 78216
  • Phone: (210) 455-1779

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NPI Details

CRYSTAL WELLNESS CENTER INC is a nurse practitioner in San Antonio, TX. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. CRYSTAL WELLNESS CENTER INC NPI is 1124583349. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6609 BLANCO RD STE 335
SAN ANTONIO, TX
ZIP 78216-504
Phone: (210) 455-1779
Fax: (210) 802-4698

The provider's authorized official is Lawrence Mack .
The authorized official title is Owner and has the following contact phone number (210) 802-4695.

The enumeration date for this NPI number is 2/1/2019 and was last updated on 8/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, RegisteredNo
2363L00000XNurse PractitionerYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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