Active NPI
Krystel Demeza, NP
- Nurse Practitioner
- Houston, TX
National Provider Identifier
1104340009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP134720
- Practice address
- 1515 Holcombe Blvd
Houston, TX 77030-4000 - Phone
- (713) 792-2991
- NPI assigned
- Aug 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AP134720 | TX | |
| Nurse Practitioner | 363L00000X | AP134720 | TX | Primary |
Addresses
Primary practice location
1515 Holcombe Blvd
Houston, TX 77030-4000
Mailing address
P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 378532102 | Medicaid | TX | |
| 378532101 | Medicaid | TX |
Other names 1
- Krystel Gaw
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517270400000",
"number": "1104340009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 4439",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104439",
"telephone_number": "713-792-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 HOLCOMBE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304000",
"telephone_number": "713-792-2991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMEZA",
"first_name": "KRYSTEL",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-01",
"last_updated": "2018-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "AP134720",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "AP134720",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "378532102",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "378532101",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KRYSTEL",
"last_name": "GAW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.