MEDICARE: CRYSTAL PINE 9889 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1740144815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRYSTAL PINE 9889 LLC

Provider Business Mailing Address
First Line	:	9889 BELLAIRE BLVD STE 134
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-3468
Country	:	US
Telephone Number	:	713-936-1300
Fax Number	:	832-519-9749

Provider Business Practice Location Address
First Line	:	9889 BELLAIRE BLVD STE 134
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-3468
Country	:	US
Telephone Number	:	713-936-1300
Fax Number	:	832-519-9749

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TZU PAO HUANG
Credential	:
Telephone Number	:	281-904-2578

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “CRYSTAL PINE 9889 LLC ” Practice Location

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