Provider Demographics
NPI:1134987464
Name:CRYSTAL HEALTHCARE INC.
Entity type:Organization
Organization Name:CRYSTAL HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHUKWUKA
Authorized Official - Last Name:OBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-891-9589
Mailing Address - Street 1:8585 COMMERCE PARK DR STE 580A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7427
Mailing Address - Country:US
Mailing Address - Phone:832-891-9589
Mailing Address - Fax:
Practice Address - Street 1:8585 COMMERCE PARK DR STE 580A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7427
Practice Address - Country:US
Practice Address - Phone:832-891-9589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care