Basic Information
Provider Information
NPI: 1649503574
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HINOJOSA
FirstName: CRYSTAL
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: ASSISTANT SPEECH LAN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1900 S. JACKSON
Address2: STE. 2 & 3
City: MCALLEN
State: TX
PostalCode: 78503
CountryCode: US
TelephoneNumber: 9566304400
FaxNumber: 9566304447
Practice Location
Address1: 1900 S. JACKSON
Address2: STE. 2 & 3
City: MCALLEN
State: TX
PostalCode: 78503
CountryCode: US
TelephoneNumber: 9566304400
FaxNumber: 9566304447
Other Information
ProviderEnumerationDate: 09/10/2009
LastUpdateDate: 09/10/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X34737TXY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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