Provider Demographics
NPI:1376520841
Name:NEVINS, CHRISTOPHER L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:NEVINS
Suffix:
Gender:M
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:PO BOX 4767
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4767
Mailing Address - Country:US
Mailing Address - Phone:713-526-5511
Mailing Address - Fax:713-520-4755
Practice Address - Street 1:1701 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1713
Practice Address - Country:US
Practice Address - Phone:713-526-5511
Practice Address - Fax:713-520-4755
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0957207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040425301Medicaid
TX110216166Medicare PIN
TXG30677Medicare UPIN
TX82438NMedicare PIN