Cryo Body Shape

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

637553 Issued in TX

Legal business name

CRYO BODY SHAPE

Practice address

7219 Glen Ellen Bay
San Antonio, TX 78244-1757

Phone

(281) 684-5412

NPI assigned

May 2, 2017

Organization subpart

No

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

Authorized official

Name

Diana Horton, REGISTERED NURSE RN

Title

Chief Nurse

Phone

(281) 684-5412

Specialties & licenses 3

Addresses

Other identifiers 3

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1285160853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7219 GLEN ELLEN BAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782441757",
            "telephone_number": "281-684-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7219 GLEN ELLEN BAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782441757",
            "telephone_number": "281-684-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYO BODY SHAPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CHIEF NURSE",
        "authorized_official_telephone_number": "281-684-5412",
        "authorized_official_credential": "REGISTERED NURSE RN"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "637553",
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "TX",
            "license": "637553",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "637553",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261Q0000X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224X000000X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261QP2000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie J Cruz, LVN
• Vanessa Cruz
• Victoria Cruz
• Elmer Ledesma Cruzado
• Ronnielyn Cruzado
• Cryst Care Homes LLC
• Crystal Clear Dental
• Crystal Counseling PLLC (Crystal Counseling)
• Crystal Counseling, PLLC
• Crystal Wellness Center Inc

• Physical Therapy Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.