Individual provider Active NPI

Crystal Lois Qualls, LVN

  • Licensed Vocational Nurse
  • Lufkin, TX
National Provider Identifier
1225512734
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
341455 Issued in TX
Practice address
1895 Old Homer Alto Rd
Lufkin, TX 75901-7923
Phone
(936) 707-4100
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 341455 TX Primary

Addresses

Primary practice location

1895 Old Homer Alto Rd
Lufkin, TX 75901-7923

Mailing address

1895 Old Homer Alto Rd
Lufkin, TX 75901-7923
Phone (936) 707-4100

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
341455TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1225512734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 OLD HOMER ALTO RD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759017923",
            "telephone_number": "936-707-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 OLD HOMER ALTO RD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759017923",
            "telephone_number": "936-707-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "CRYSTAL",
        "middle_name": "LOIS",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "341455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.