Provider Demographics
NPI:1215674411
Name:ONYEADOR, CRYSTAL CHINELO (OD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:CHINELO
Last Name:ONYEADOR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W FM 1382 STE 500
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-1889
Mailing Address - Country:US
Mailing Address - Phone:972-299-9988
Mailing Address - Fax:
Practice Address - Street 1:305 W FM 1382 STE 500
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-1889
Practice Address - Country:US
Practice Address - Phone:972-299-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11304TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist