Provider Demographics
NPI:1346207255
Name:LUX, CHRISTOPHER L
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:LUX
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 1:2602 SAINT MICHAEL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2387
Mailing Address - Country:US
Mailing Address - Phone:903-614-5111
Mailing Address - Fax:903-614-5114
Practice Address - Street 1:2602 SAINT MICHAEL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2387
Practice Address - Country:US
Practice Address - Phone:903-614-5111
Practice Address - Fax:903-614-5114
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K575OtherBCBS ARKANSAS
OK200120690AOtherOKLAHOMA HEALTHCARE AUTHO
TXP00466535OtherRR MEDICARE
AR112378001Medicaid
TX176094401Medicaid
TX8X9803OtherBCBS TEXAS
TX176094401Medicaid
AR5K575OtherBCBS ARKANSAS
TXP00466535OtherRR MEDICARE
AR5K575Medicare PIN