Crystal Latrice Champion-Kendricks, PHARM D
Individual provider Active NPI Pharmacist · Stafford, TX
NPI 1598092967 · NPPES record last updated Jan 24, 2023
Key facts
- NPI
- 1598092967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 041510 (TX)
- Practice address
- 11104 W Airport Blvd Ste 214
Stafford, TX 77477-3197 - Phone
- (713) 777-6251
- Fax
- (903) 923-0661
- NPI assigned
- Nov 5, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041510 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellaire Pharmacy, LLC | Current |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
11104 W Airport Blvd
Ste 214
Stafford, TX 77477
Phone (713) 777-6251
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 041510 | TX | Yes |
Addresses
Primary practice location
11104 W Airport Blvd Ste 214
Stafford, TX 77477-3197
Mailing address
11104 W Airport Blvd Ste 214
Stafford, TX 77477-3197
Phone (713) 777-6251
Other providers in Stafford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.