Provider Demographics
NPI:1275926941
Name:GUMBS, CHRISTEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:GUMBS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 W SLAUGHTER LN
Mailing Address - Street 2:STE 475
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6230
Mailing Address - Country:US
Mailing Address - Phone:512-520-4242
Mailing Address - Fax:512-782-0287
Practice Address - Street 1:1807 W SLAUGHTER LN
Practice Address - Street 2:STE 475
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6230
Practice Address - Country:US
Practice Address - Phone:512-520-4242
Practice Address - Fax:512-782-0287
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1255397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00636YMedicare PIN
TX423648YLHEMedicare PIN
TX423648YT6UMedicare PIN
TX00X553Medicare PIN