Provider Demographics
NPI:1033156054
Name:MOORE, CHRISTINE C (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:C
Last Name:MOORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 CHASE OAKS BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4652
Mailing Address - Country:US
Mailing Address - Phone:469-467-1125
Mailing Address - Fax:
Practice Address - Street 1:6200 CHASE OAKS BLVD
Practice Address - Street 2:STE 104
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4652
Practice Address - Country:US
Practice Address - Phone:469-467-1125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601890Medicare ID - Type Unspecified
TXU14170Medicare UPIN