Individual provider Active NPI

Crystol Marie Hill Inocencio, PTA

  • Physical Therapy Assistant
  • Ore City, TX
National Provider Identifier
1104763705
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2064230 Issued in TX
Practice address
704 N Peach St
Ore City, TX 75683-2312
Phone
(956) 645-1274
NPI assigned
May 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 2064230 TX Primary

Addresses

Primary practice location

704 N Peach St
Ore City, TX 75683-2312

Mailing address

704 N Peach St
Ore City, TX 75683-2312
Phone (956) 645-1274

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2064230TXMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1104763705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 N PEACH ST",
            "city": "ORE CITY",
            "state": "TX",
            "postal_code": "756832312",
            "telephone_number": "956-645-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N PEACH ST",
            "city": "ORE CITY",
            "state": "TX",
            "postal_code": "756832312",
            "telephone_number": "956-645-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL INOCENCIO",
        "first_name": "CRYSTOL",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2064230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ore City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.