Provider Demographics
NPI:1114300878
Name:WEBB, CRYSTIN (OD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTIN
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 HALL JOHNSON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5896
Mailing Address - Country:US
Mailing Address - Phone:817-428-0400
Mailing Address - Fax:
Practice Address - Street 1:1213 HALL JOHNSON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5896
Practice Address - Country:US
Practice Address - Phone:817-428-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8689T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist