Provider Demographics
NPI:1316348659
Name:PARRISH, CRYSTAL
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 UPTOWN BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3538
Mailing Address - Country:US
Mailing Address - Phone:469-272-3129
Mailing Address - Fax:469-272-3145
Practice Address - Street 1:638 UPTOWN BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3538
Practice Address - Country:US
Practice Address - Phone:469-272-3129
Practice Address - Fax:469-272-3145
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2050273225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant