Provider Demographics
NPI:1194855601
Name:CHRISTIE, JOHN J (DC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12421 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-467-5367
Mailing Address - Fax:713-467-0937
Practice Address - Street 1:12421 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-467-5367
Practice Address - Fax:713-467-0937
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T12650Medicare UPIN
TX600039Medicare PIN