Provider Demographics
NPI:1932079720
Name:PRISTINE PRACTICES LLC
Entity type:Organization
Organization Name:PRISTINE PRACTICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYPRIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ND
Authorized Official - Phone:409-454-5105
Mailing Address - Street 1:5300 ROSEMARY DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-1932
Mailing Address - Country:US
Mailing Address - Phone:409-454-5105
Mailing Address - Fax:
Practice Address - Street 1:5300 ROSEMARY DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-1932
Practice Address - Country:US
Practice Address - Phone:409-454-5105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service