Provider Demographics
NPI:1447213368
Name:QUIRANTE, CHRISTOPHER ELEFANO (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ELEFANO
Last Name:QUIRANTE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VIDOR
Mailing Address - State:TX
Mailing Address - Zip Code:77662-4935
Mailing Address - Country:US
Mailing Address - Phone:409-783-2277
Mailing Address - Fax:409-783-2701
Practice Address - Street 1:395 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662-4935
Practice Address - Country:US
Practice Address - Phone:409-783-2277
Practice Address - Fax:409-783-2701
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03015363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y3692OtherBCBSTX
TX8Y3692OtherBCBSTX
TX8K2998Medicare PIN