Provider Demographics
NPI:1487679874
Name:SOUDERS, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SOUDERS
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 1:600 JEFFERSON ST
Mailing Address - Street 2:8TH FL
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-7363
Mailing Address - Country:US
Mailing Address - Phone:832-394-6812
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERSON ST
Practice Address - Street 2:8TH FL
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-7363
Practice Address - Country:US
Practice Address - Phone:832-394-6812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2671207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148658101Medicaid
TX8211B0Medicare PIN
H54506Medicare UPIN