CRYSTAL PARK
NPI 1043911936
Nurse Practitioner - Acute Care in Houston, TX

Q: What is Crystal Park's NPI number?

The NPI number for Crystal Park is 1043911936. It was assigned to this individual provider in the NPPES registry on March 16, 2023.

Q: What is Crystal Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Crystal Park was last updated on March 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 16, 2023PECOS Enrolled

6411 FANNIN ST, HOUSTON, TX 77030(713) 704-4000 Get Directions Write a Review

NPPES record last updated: March 19, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Crystal Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL PARK (NPI 1043911936) is an individual acute care provider in Houston, Texas, licensed in Texas (1103075) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1043911936

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameCRYSTAL PARK

Location Address6411 FANNIN STHouston, TX 77030-1501

Mailing Address3300 16th St Nw Apt 813Washington, DC 20010-2259 · (301) 706-1734

Phone(713) 704-4000

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 16, 2023

Last NPPES UpdateMarch 19, 2023

NPPES CertifiedMarch 19, 2023

✔ NPI 1043911936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in TX · 1103075

6411 FANNIN ST, Houston, TX 77030

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416442603

PECOS Enrollment IDI20251224002348

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.40 typical visit price

range $58.24 – $176.98

Typical copayment $22.60 (range $14.56 – $44.24)

Most-billed visit code 99203

Established Patient

$102.71 typical visit price

range $18.60 – $143.93

Typical copayment $25.67 (range $4.65 – $35.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HASHIM ZAIDI M.D.

Emergency Medicine