Provider Demographics
NPI:1003548991
Name:POIGNARD, CHRISTINA M (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:POIGNARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8324 EDGEPOINT TRL
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-7447
Mailing Address - Country:US
Mailing Address - Phone:817-846-2340
Mailing Address - Fax:
Practice Address - Street 1:1251 E SOUTHLAKE BLVD STE 331
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6478
Practice Address - Country:US
Practice Address - Phone:817-663-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10438152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist