Crystal Lucio

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

110296 Issued in TX

Practice address

401 Long St
Hereford, TX 79045-3227

Phone

(806) 206-5191

NPI assigned

Aug 16, 2022

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Aug 16, 2022.

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1831817816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 LONG ST",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790453227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LONG ST",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790453227",
            "telephone_number": "806-206-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIO",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hereford, TX
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.