Provider Demographics
NPI:1508753427
Name:CROWNED CRYSTAL CORPORATION
Entity type:Organization
Organization Name:CROWNED CRYSTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:JUDSON
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSM, HHP
Authorized Official - Phone:214-601-8648
Mailing Address - Street 1:PO BOX 851
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-0851
Mailing Address - Country:US
Mailing Address - Phone:214-601-8648
Mailing Address - Fax:
Practice Address - Street 1:2622 LAVENDER LN
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-2156
Practice Address - Country:US
Practice Address - Phone:225-678-8624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No251E00000XAgenciesHome Health