Provider Demographics
NPI:1427614833
Name:LINSTEADT, CRYSTAL DAWN (LMT)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:DAWN
Last Name:LINSTEADT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 LANDERSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-6213
Mailing Address - Country:US
Mailing Address - Phone:972-971-2641
Mailing Address - Fax:
Practice Address - Street 1:3112 LANDERSHIRE LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-6213
Practice Address - Country:US
Practice Address - Phone:972-971-2641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT129385225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty