=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871809673
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRYSTAL BARNETT CALDWELL D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2010
-----------------------------------------------------
Last Update Date | 02/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2930 PRESTON RD STE 120
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-9054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-436-5420
-----------------------------------------------------
Fax | 214-975-1974
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4808 HWY 121 STE 120
-----------------------------------------------------
City | THE COLONY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75056-2915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-843-8475
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NN0400X
-----------------------------------------------------
Taxonomy Name | Neurology Chiropractor
-----------------------------------------------------
License Number | 11446
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111NN1001X
-----------------------------------------------------
Taxonomy Name | Nutrition Chiropractor
-----------------------------------------------------
License Number | 11446
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------