Provider Demographics
NPI:1164585105
Name:CRIST, QUYNH-THI (OD)
Entity Type:Individual
Prefix:DR
First Name:QUYNH-THI
Middle Name:
Last Name:CRIST
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 1:5304 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2529
Mailing Address - Country:US
Mailing Address - Phone:713-520-7750
Mailing Address - Fax:
Practice Address - Street 1:5304 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2529
Practice Address - Country:US
Practice Address - Phone:713-520-7750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5500TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU70178Medicare UPIN
TX00221HMedicare ID - Type Unspecified