Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crystal Park

Individual provider Acute Care Nurse Practitioner · NPI 1043911936

Crystal Park is a Nurse Practitioner in Houston, Texas. Qualified in 2023, 3 years ago. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2023
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Practice location Address checks out

6411 Fannin St
Houston, TX 77030-1501
Phone: (713) 704-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 1103075 (TX)

Record details

NPI number1043911936
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 16, 2023
Last updated in NPPESMarch 19, 2023
Certification dateMarch 19, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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