Active NPI
Crystal Ross, ST
- Speech-Language Pathologist
- Katy, TX
National Provider Identifier
1366527921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 16459
- Practice address
- 21304 Provincial Blvd
Katy, TX 77450-7580 - Phone
- (832) 293-0660
- Fax
- (800) 803-7888
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 16459 | TX | Primary |
Addresses
Primary practice location
21304 Provincial Blvd
Katy, TX 77450-7580
Mailing address
2402 Horned Owl Dr
Katy, TX 77494-1928
Phone (832) 293-0660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 354252401 | Medicaid | TX |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16459 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1366527921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2402 HORNED OWL DR",
"city": "KATY",
"state": "TX",
"postal_code": "774941928",
"telephone_number": "832-293-0660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21304 PROVINCIAL BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774507580",
"telephone_number": "832-293-0660",
"fax_number": "800-803-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "CRYSTAL",
"credential": "ST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "16459",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "354252401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.