Provider Demographics
NPI:1093120503
Name:NEWCOMB, CHRISTPHER
Entity Type:Individual
Prefix:
First Name:CHRISTPHER
Middle Name:
Last Name:NEWCOMB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 NORTHWEST HWY
Mailing Address - Street 2:SUITE G
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5851
Mailing Address - Country:US
Mailing Address - Phone:972-698-0615
Mailing Address - Fax:
Practice Address - Street 1:1250 NORTHWEST HWY
Practice Address - Street 2:SUITE G
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5851
Practice Address - Country:US
Practice Address - Phone:972-698-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80639237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist