Provider Demographics
NPI:1407576572
Name:ARREOLA, CRISTAL ALEXIS
Entity Type:Individual
Prefix:MRS
First Name:CRISTAL
Middle Name:ALEXIS
Last Name:ARREOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4764 GREY WOLF LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-1685
Mailing Address - Country:US
Mailing Address - Phone:432-238-2118
Mailing Address - Fax:
Practice Address - Street 1:3177 EXECUTIVE DR STE B
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6801
Practice Address - Country:US
Practice Address - Phone:325-500-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2022027200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily