Provider Demographics
NPI:1972765725
Name:FRANK, CRYSTAL ANN (OTR)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:FRANK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E TYLER ST APT 202
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-7282
Mailing Address - Country:US
Mailing Address - Phone:903-600-6797
Mailing Address - Fax:
Practice Address - Street 1:110 E TYLER ST APT 202
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-7282
Practice Address - Country:US
Practice Address - Phone:903-600-6797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112694225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist