Individual
CRYSTAL SUSTAITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3501 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(325) 949-9511
Mailing address
3605 EXECUTIVE DR, SAN ANGELO, TX 76904-6884
(325) 949-9555
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
746452
TX
Other
Enumeration date
09/11/2015
Last updated
12/05/2018
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