Provider Demographics
NPI:1023183712
Name:PATRONELLA, CHRISTOPHER KEVEN (M D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KEVEN
Last Name:PATRONELLA
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12727 KIMBERLEY LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4047
Mailing Address - Country:US
Mailing Address - Phone:713-799-9999
Mailing Address - Fax:713-722-8998
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-799-9999
Practice Address - Fax:713-722-8998
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3674174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE04531Medicare UPIN
TX89450BMedicare ID - Type Unspecified