Active NPI
Krystal O'Donald
- Mechanotherapist
- Dallas, TX
National Provider Identifier
1851838890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 124067
- Practice address
- 1409 S Lamar St Apt 834
Dallas, TX 75215-6848 - Phone
- (972) 971-2869
- NPI assigned
- Jan 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 124067 | TX | Primary |
| Reflexologist | 173C00000X | 124067 | TX |
Addresses
Primary practice location
1409 S Lamar St Apt 834
Dallas, TX 75215-6848
Mailing address
1409 S Lamar St Apt 834
Dallas, TX 75215-6848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124067 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485648000000",
"number": "1851838890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 S LAMAR ST APT 834",
"city": "DALLAS",
"state": "TX",
"postal_code": "752156848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 S LAMAR ST APT 834",
"city": "DALLAS",
"state": "TX",
"postal_code": "752156848",
"telephone_number": "972-971-2869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DONALD",
"first_name": "KRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-29",
"last_updated": "2017-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "TX",
"license": "124067",
"primary": true
},
{
"code": "173C00000X",
"taxonomy_group": "",
"desc": "Reflexologist",
"state": "TX",
"license": "124067",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.