Provider Demographics
NPI:1467450908
Name:BELL, CHRISTOPHER A (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:BELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S TWIN CITY HWY
Mailing Address - Street 2:102
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-4204
Mailing Address - Country:US
Mailing Address - Phone:409-729-2266
Mailing Address - Fax:409-729-2626
Practice Address - Street 1:520 S TWIN CITY HWY
Practice Address - Street 2:102
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-4204
Practice Address - Country:US
Practice Address - Phone:409-729-2266
Practice Address - Fax:409-729-2626
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-10-15
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
TXJ9625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113220104Medicaid
TXG38081Medicare UPIN
TX113220104Medicaid