Provider Demographics
NPI:1073094496
Name:ALQUIZA, CHRISTIE TABLIZO JR (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:TABLIZO
Last Name:ALQUIZA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:ALQUIZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:17521 US HIGHWAY 69 S STE 120
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5596
Mailing Address - Country:US
Mailing Address - Phone:903-839-3600
Mailing Address - Fax:903-839-4100
Practice Address - Street 1:8300 ELDORADO PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5946
Practice Address - Country:US
Practice Address - Phone:972-548-9339
Practice Address - Fax:972-569-9330
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10721892251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics