Healthcare Provider Details

I. General information

NPI: 1497294425
Provider Name (Legal Business Name): CHRYSTAL L KEYS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 ROBBIE MINCE WAY
DESOTO TX
75115-2012
US

IV. Provider business mailing address

1001 ROBBIE MINCE WAY
DESOTO TX
75115-2012
US

V. Phone/Fax

Practice location:
  • Phone: 972-709-7190
  • Fax: 972-780-4796
Mailing address:
  • Phone: 972-709-7190
  • Fax: 972-780-4796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP132839
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: