Provider Demographics
NPI:1437320256
Name:SELL, CHRISTIAN ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ALLEN
Last Name:SELL
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 1:4102 RICHMOND MDWS
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0067
Mailing Address - Country:US
Mailing Address - Phone:903-223-1014
Mailing Address - Fax:903-223-1028
Practice Address - Street 1:4102 RICHMOND MDWS
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0067
Practice Address - Country:US
Practice Address - Phone:903-223-1014
Practice Address - Fax:903-223-1028
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1028302085R0202X
TXP79492085R0202X
ARE80812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX306216YT8JMedicare PIN
AR306216YT9SMedicare PIN