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General NPI Number Information
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NPI Number | 1326380049
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Entity Type | Individual
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Provider Name | CRYSTAL PURDON CNIM
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Gender | Female
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 803 SPRING SOURCE PLACE
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City | SPRING
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State | TX
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Zip | 77373
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Country | US
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Telephone | 281-740-2948
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Fax | 281-528-0243
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Provider Business Mailing Address
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Address Line | 803 SPRING SOURCE PL
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City | SPRING
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State | TX
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Zip | 77373-7077
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Country | US
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Telephone | 281-740-2948
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Fax | 281-528-0243
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | 1082
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License Number State | TX
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