Individual
CRYSTAL WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
4204 GARDENDALE ST STE 107, SAN ANTONIO, TX 78229-3138
(210) 334-0108
Mailing address
214 KIMBERLY DR, CONVERSE, TX 78109-1530
(210) 570-0214
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1015357
OR
163W00000X
Registered Nurse
913829
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1216753
TX
Other
Enumeration date
04/16/2025
Last updated
12/11/2025
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