Provider Demographics
NPI:1457092108
Name:BEAVERS, CHRISTOPHER JAMES (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:BEAVERS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:BEAVERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19722 CAROLING OAKS CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1247
Mailing Address - Country:US
Mailing Address - Phone:281-660-2193
Mailing Address - Fax:
Practice Address - Street 1:19722 CAROLING OAKS CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1247
Practice Address - Country:US
Practice Address - Phone:281-660-2193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily