Crystal Ann Wostarek

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2048066 Issued in TX

Practice address

636 Cupples Rd
San Antonio, TX 78237-4328

Phone

(210) 237-1883

NPI assigned

Nov 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574899200000",
    "number": "1518504380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 E FM 1518 N",
            "city": "SAINT HEDWIG",
            "state": "TX",
            "postal_code": "781529747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CUPPLES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782374328",
            "telephone_number": "210-237-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOSTAREK",
        "first_name": "CRYSTAL ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-28",
        "last_updated": "2019-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2048066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "225200000X",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "address_1": "636 Cupples Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782374328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barry G Wortham, MD
• Dashawn Wortham
• Joy Marissa Wortham, M.D.
• William Wortham, M.D.
• Keri Wortherly
• Wound Care and Limb Salvage Specialty Group
• Wound Healing Partners PLLC
• Wound Professional Services of San Antonio
• Wound Professional Services of San Antonio
• Wound Professional Services of San Antonio PA

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2019; 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.