Provider Demographics
NPI:1326083270
Name:CRYSTAL EYECARE, P.A.
Entity Type:Organization
Organization Name:CRYSTAL EYECARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-304-5060
Mailing Address - Street 1:16910 THOMAS RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3956
Mailing Address - Country:US
Mailing Address - Phone:281-304-5060
Mailing Address - Fax:281-304-5070
Practice Address - Street 1:13611 SKINNER RD
Practice Address - Street 2:SUITE 155
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1771
Practice Address - Country:US
Practice Address - Phone:281-304-5060
Practice Address - Fax:281-304-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty