Individual
CRYSTAL LANE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EMTP
Contact information
Practice address
736 LAKE CAROLYN PKWY APT 146W, IRVING, TX 75039-3995
(214) 923-1596
Mailing address
736 LAKE CAROLYN PKWY APT 146W, IRVING, TX 75039-3995
(214) 923-1596
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
717837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
717837
HHS
TX
Enumeration date
08/14/2020
Last updated
08/14/2020
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