Crystal Life Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CRYSTAL LIFE PHARMACY INC

Doing business as

Crystal Life Pharmacy Inc

Practice address

1441 Coit Rd Ste F
Plano, TX 75075-7768

Phone

(469) 209-6074

Fax

(469) 209-6074

NPI assigned

Sep 20, 2023

Organization subpart

No

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

Authorized official

Name

Helen Ekutti

Title

Manager

Phone

(972) 449-0800

Specialties & licenses 2

Addresses

Other names 1

• Crystal Life Pharmacy Inc Doing business as

Locations

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706400000000",
    "number": "1396523387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 COIT RD STE F",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757768",
            "telephone_number": "469-209-6074",
            "fax_number": "469-209-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 COIT RD STE F",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757768",
            "telephone_number": "469-209-6074",
            "fax_number": "469-209-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL LIFE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A",
        "authorized_official_last_name": "EKUTTI",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-449-0800"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Life Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crystal Life Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrier A. Crutcher, LPC
• Nicole Elizabeth Cruz, PA-C
• Jillian Cruzet
• Debra Kay Cryer, LVN
• Crystal Creek Dental
• Daffney Bryan Cseke
• CSTX Behavioral Health PLLC
• CT Dental PLLC
• Jonathan Thang Cu, BSN-RN
• Maya Kristina Cuellar, BCBA

• Community/Retail Pharmacy in Plano, TX
• Providers in Plano, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; 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.