Healthcare Provider Details

I. General information

NPI: 1477462596
Provider Name (Legal Business Name): CRYSTAL TINDALL FNP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 UNIVERSITY DR E
BRYAN TX
77802-3473
US

IV. Provider business mailing address

PO BOX 451
LYONS TX
77863-0451
US

V. Phone/Fax

Practice location:
  • Phone: 979-731-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. CRYSTAL TINDALL
Title or Position: MANAGING MEMBER
Credential: NP
Phone: 979-731-3100