Provider Demographics
NPI:1689315517
Name:CRYSTAL STEPS THERAPY INC
Entity Type:Organization
Organization Name:CRYSTAL STEPS THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OPEOLUWA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADARU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-614-8536
Mailing Address - Street 1:6418 PAPAYA BEND DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5126
Mailing Address - Country:US
Mailing Address - Phone:850-567-9292
Mailing Address - Fax:
Practice Address - Street 1:6418 PAPAYA BEND DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5126
Practice Address - Country:US
Practice Address - Phone:850-567-9292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy