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General NPI Number Information
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NPI Number | 1740113760
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Entity Type | Organization
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Legal Business Name | CRYSTALLINE DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 5900 BALCONES DR STE 31744
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 346-421-2776
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 31744
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 346-421-2776
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. ANGELA FOUSEK
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Credential |
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Telephone | 346-421-2776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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