Crystal Wellness Center Inc
NPI 1124583349ActiveOrganization· Nurse Practitioner· San Antonio, TX
Nurse Practitioner in San Antonio, Texas, registered in NPPES in February 2019. The authorized official on file is Lawrence Mack, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124583349 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 1, 2019 |
| Last updated in NPPES | Aug 19, 2024 |
| Certified by provider | Aug 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Dietitian, Registered | 133V00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
Other Nurse Practitioner providers in San Antonio
- 1235660507
- 1639032055
- 1033358049
- 1801613120
- 1285109272
- 1447886544
- 1043774383
- 1871371799
- 1629967500
- 1073162160
- 1053103010
- 1679665244