| Name: | Luz T. Crystal, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 28 Jan 2009 (16 years ago) |
| Entity Number: | 000-259-871 |
| Register Number: | 000259871 |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Principal Address: | FORT PAYNE, AL |
| Registered Office Street Address: | 2202 JORDAN RD SWFORT PAYNE, AL 35968 |
| Registered Office Street Address ZIP Code: | 35968 |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | $5,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417198946 | 2009-03-12 | 2009-03-12 | 2202 JORDAN RD SW, FORT PAYNE, AL, 359683688, US | 2202 JORDAN RD SW, FORT PAYNE, AL, 359683688, US | |||||||||||||||||||
|
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| Phone | +1 256-844-2825 |
| Fax | 2568451804 |
Authorized person
| Name | DR. LUZ TORRALBA CRYSTAL |
| Role | PRESIDENT |
| Phone | 2568442825 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 18535 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CRYSTAL, LUZ T | Agent |
| Name | Role |
|---|---|
| CRYSTAL, LUZ T | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
