Provider Demographics
NPI:1699750471
Name:CRISTOL, LOUIS (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:CRISTOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 OLD HIGHWAY 1187
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0281
Mailing Address - Country:US
Mailing Address - Phone:682-268-6700
Mailing Address - Fax:682-268-6701
Practice Address - Street 1:209 OLD HIGHWAY 1187
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0281
Practice Address - Country:US
Practice Address - Phone:822-686-7006
Practice Address - Fax:682-268-6701
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5432207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110160853OtherMEDICARE RAILROAD PIN
TX84980JOtherBLUE CROSS PIN
TX042848401Medicaid
TX060025381OtherMEDICARE RAILROAD
TX110160853OtherMEDICARE RAILROAD PIN
TX84980JOtherBLUE CROSS PIN
TXF87417Medicare UPIN