Provider Demographics
NPI:1083620413
Name:PRIHODA, CHRISTOPHER D (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:PRIHODA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 W PANTHER CREEK DR
Mailing Address - Street 2:#345
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3579
Mailing Address - Country:US
Mailing Address - Phone:281-292-1192
Mailing Address - Fax:281-367-0396
Practice Address - Street 1:4775 WEST PANTHER CREEK DR
Practice Address - Street 2:#345
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381
Practice Address - Country:US
Practice Address - Phone:281-292-1192
Practice Address - Fax:281-367-0396
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8G7773Medicare PIN