OrganizationActive
Crystal Wellness Center Inc
NPI 1124583349 · Nurse Practitioner · San Antonio, TX
Provider details
- NPI number
- 1124583349
- Entity type
- Organization
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Lawrence Mack, Owner(210) 802-4695
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Registered Dietitian133V00000X
Dietary & Nutritional Service Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6609 Blanco Rd Ste 335
San Antonio, TX 78216-4504
Phone: (210) 455-1779
Fax: (210) 802-4698
Street-level locationGet directions
Mailing address
116 Gallery Cir Ste 201
San Antonio, TX 78258-3341
Additional practice locations (1)
- 116 Gallery Cir Ste 201San Antonio, TX 78258-3341Phone: (210) 802-4695Fax: (210) 802-4698
Registry dates
- Enumerated
- 2019-02-01
- Last updated
- 2024-08-19
- Certified
- 2024-08-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.