Crystal Beach Ventures LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

017585 Issued in TX

Legal business name

CRYSTAL BEACH VENTURES LLC

Practice address

2121 Market St
Suite 101
Galveston, TX 77550-1689

Phone

(409) 974-4935

Fax

(409) 632-7980

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Mike Willett

Title

President

Phone

(713) 868-6112

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1538610530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MARKET ST",
            "address_2": "SUITE 101",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775501689",
            "telephone_number": "409-974-4935",
            "fax_number": "409-632-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 MARKET ST",
            "address_2": "SUITE 101",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775501689",
            "telephone_number": "409-974-4935",
            "fax_number": "409-632-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL BEACH VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "WILLETT",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-868-6112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "017585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Croegaert, M.S. CCC-SLP
• Kevin Lewis Crosson, EMT-B
• Bianca Crowley
• Karl Vincent Crudo, M.D.
• Maria Isabella Cruz, DO
• Christopher Csengery, D.D.S.
• Servando Cuellar III, MD
• Marisa Cueva, NP-C
• Kaitlyn Culp, PA-C
• Josephine Cumberbatch, NP

• Home Health Agency in Galveston, TX
• Providers in Galveston, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.