CRYSTAL BEACH MEDICAL CLINIC LLC
NPI 1114948825
Family Medicine in Crystal Beach, TX

Q: What is Crystal Beach Medical Clinic LLC's NPI number?

The NPI number for Crystal Beach Medical Clinic LLC is 1114948825. It was assigned to this organization in the NPPES registry on July 21, 2006.

Q: What is Crystal Beach Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since July 21, 2006

955 S. EAST RD., CRYSTAL BEACH, TX 77650(409) 454-2543(866) 521-5608 Get Directions Write a Review

NPPES record last updated: January 13, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Crystal Beach Medical Clinic Llc NPPES

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

CRYSTAL BEACH MEDICAL CLINIC LLC (NPI 1114948825) is a healthcare organization registered as a family medicine in Crystal Beach, Texas and active in the NPI registry since July 2006. The organization lists Bruce Lever Mitchell, Member, as its authorized official.

NPPES Registry Identity

NPI1114948825

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameCRYSTAL BEACH MEDICAL CLINIC LLC

Location Address955 S. EAST RD.Crystal Beach, TX 77650-1449

Mailing AddressPo Box 1449Crystal Beach, TX 77650-1449 · (409) 454-2543

Phone(409) 454-2543

Fax(866) 521-5608

Organization SubpartNo

Authorized OfficialBruce Lever MitchellMember · (409) 454-2543

Enumeration DateJuly 21, 2006

Last NPPES UpdateJanuary 13, 2009

✔ NPI 1114948825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

955 S. EAST RD., Crystal Beach, TX 77650

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Other Identifiers 4

Medicare PINDF2287

Medicare PIN00W709TX

Medicaid182389001TX

Medicaid182389002TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Beach Medical Clinic LLC's NPI number?

The NPI number for Crystal Beach Medical Clinic LLC is 1114948825. It was assigned to this organization in the NPPES registry on July 21, 2006.

Where is Crystal Beach Medical Clinic LLC located?

Crystal Beach Medical Clinic LLC is located at 955 S. East Rd., Crystal Beach, TX 77650. The listed phone number is (409) 454-2543.

What is Crystal Beach Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Crystal Beach Medical Clinic LLC was last updated on January 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.