Provider Demographics
NPI:1225028566
Name:STURM, CRYSTAL (PA)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:
Last Name:STURM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAIN PLZ # 322
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5136
Mailing Address - Country:US
Mailing Address - Phone:830-627-2700
Mailing Address - Fax:830-627-2701
Practice Address - Street 1:66 GRUENE PARK DR STE 109
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2460
Practice Address - Country:US
Practice Address - Phone:830-627-2700
Practice Address - Fax:830-627-2701
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03484363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ24915Medicare UPIN
TX8D9651Medicare ID - Type Unspecified