Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2145 | TX |
Y | 222Z00000X | Podiatrist | 2145 | TX |
NPI | 1013263946 |
---|---|
Provider Name | Dr. Christopher David Correa |
First Address | Cypress, TX 77429-1038 |
Second Address | Cypress, TX 77429-1038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2012 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
346947001 | (05) | TX |
8FC085 | BLUE CROSS & BLUE SHIELD (01) | TX |
P01555988 | RAIL ROAD MEDICARE (01) | TX |