Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 25235 | TX |
N | 1223G0001X | General Practice | 8594 | CO |
N | 213EG0000X | General Practice | 8594 | CO |
NPI | 1003093717 |
---|---|
Provider Name | Dr. Richard Kevin Christiansen |
First Address | San Antonio, TX 78258-4560 |
Second Address | San Antonio, TX 78250-6841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2008 |
Last Update Date | 09/12/2010 |