Crystal Outpatient Surgery Center

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

H2191 Issued in TX

Legal business name

CRYSTAL OUTPATIENT SURGERY CENTER

Practice address

10565 Katy Freeway
Suite 100
Houston, TX 77024

Phone

(713) 467-0146

Fax

(713) 467-9413

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bret Wayne Broker

Title

Executive Director

Phone

(713) 467-0146

Specialties & licenses 1

Addresses

Other names 1

• Town & Country Plastic Surgery Doing business as

Locations

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295880219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10565 KATY FREEWAY",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-467-0146",
            "fax_number": "713-467-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10565 KATY FREEWAY",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-467-0146",
            "fax_number": "713-467-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL OUTPATIENT SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROKER",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "713-467-0146",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "H2191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town & Country Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Blue Sapphire HCS LLC
• Crystal EMS Inc
• Crystal Health Care Services, Inc
• Crystal Healthcare Inc.
• Crystal Klear Optical
• Crystal Outpatient Surgery Center Lake Jackson
• Crystal Pine 9889 LLC
• Crystal Swamp Collabs, PLLC
• Kelly Crystal, PA-C
• CS Life Coaching

• Plastic Surgery Physician in Houston, TX
• Providers in Houston, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.