Provider Demographics
NPI:1053329904
Name:MORGAN, CHRISTOPHER BRENT (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRENT
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 MEDICAL DRIVE
Mailing Address - Street 2:STE C
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801
Mailing Address - Country:US
Mailing Address - Phone:903-729-1552
Mailing Address - Fax:903-729-7635
Practice Address - Street 1:123 MEDICAL DRIVE
Practice Address - Street 2:STE C
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801
Practice Address - Country:US
Practice Address - Phone:903-729-1552
Practice Address - Fax:903-729-7635
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1366213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045746701Medicaid
TX87751FOtherBCBS
TX118711OtherCHIPS
U66552Medicare UPIN
TX118711OtherCHIPS