Provider Demographics
NPI:1376509224
Name:COLUMBUS, CRISTIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIE
Middle Name:
Last Name:COLUMBUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 WORTH ST
Mailing Address - Street 2:710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2029
Mailing Address - Country:US
Mailing Address - Phone:214-823-2533
Mailing Address - Fax:214-824-8679
Practice Address - Street 1:3409 WORTH ST
Practice Address - Street 2:710
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2029
Practice Address - Country:US
Practice Address - Phone:214-823-2533
Practice Address - Fax:214-824-8679
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6125174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist