Provider Demographics
NPI:1922325414
Name:WHITBY, CRYSTAL (PA)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:WHITBY
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 1:4707 EIGEL ST.
Mailing Address - Street 2:STE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3417
Mailing Address - Country:US
Mailing Address - Phone:713-960-1311
Mailing Address - Fax:713-960-1325
Practice Address - Street 1:4707 EIGEL ST.
Practice Address - Street 2:STE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3417
Practice Address - Country:US
Practice Address - Phone:713-960-1311
Practice Address - Fax:713-960-1325
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06613363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical