Organization
KRYSTAL FAMILY PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYNA NKEMJIKA OMENUKOR (CEO)
(469) 231-7232
Entity
Organization
Contact information
Practice address
1675 REPUBLIC PKWY STE 104, MESQUITE, TX 75150-6902
(469) 231-7232
Mailing address
1675 REPUBLIC PKWY STE 190, MESQUITE, TX 75150-6902
(469) 231-7232
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
08/15/2024
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