Provider Demographics
NPI:1104624840
Name:KRYSTLE EXPRESS
Entity type:Organization
Organization Name:KRYSTLE EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-401-7103
Mailing Address - Street 1:2542 WHITE BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77038-2728
Mailing Address - Country:US
Mailing Address - Phone:346-401-7103
Mailing Address - Fax:
Practice Address - Street 1:2542 WHITE BLUFF LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77038-2728
Practice Address - Country:US
Practice Address - Phone:346-401-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)