Individual
CRYSTAL BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
13915 BURNET RD STE 303, AUSTIN, TX 78728-6505
(512) 996-9559
Mailing address
2615 HOMAN AVE, WACO, TX 76707-1931
(254) 981-0454
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
333969
TX
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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