Individual provider Active NPI

Krystal Lauren Raquet

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1306304902
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1053028 Issued in TX
Practice address
10410 Doherty SPG
San Antonio, TX 78255-1041
Phone
(210) 395-4520
Fax
(210) 395-4521
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1053028 TX Primary

Addresses

Primary practice location

10410 Doherty SPG
San Antonio, TX 78255-1041

Mailing address

10410 Doherty SPG
San Antonio, TX 78255-1041
Phone (210) 395-4520

Other practice location 1

11306 Sir Winston St Bldg F
San Antonio, TX 78216-2467
Phone (210) 366-0049

Other names 1

  • Krystal Lauren Salas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260522002178 TX Practitioner - Nurse Practitioner 4284104902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10410 Doherty SPG
San Antonio, TX 78255-1041

4810 Spicewood Springs Rd
BLDG B
Austin, TX 78759-7838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1053028TXMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1306304902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10410 DOHERTY SPG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782551041",
            "telephone_number": "210-395-4520",
            "fax_number": "210-395-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 DOHERTY SPG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782551041",
            "telephone_number": "210-395-4520",
            "fax_number": "210-395-4521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11306 Sir Winston St Bldg F",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782162467",
            "country_code": "US",
            "telephone_number": "210-366-0049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAQUET",
        "first_name": "KRYSTAL",
        "middle_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1053028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "SALAS",
            "middle_name": "LAUREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.