Provider Demographics
NPI:1497835680
Name:BRADEN, CHRISTOPHER DAVID (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:BRADEN
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:214-234-0813
Practice Address - Street 1:1448 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3162
Practice Address - Country:US
Practice Address - Phone:830-643-1762
Practice Address - Fax:830-609-7702
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003326A207RH0003X
KY03025207RH0003X
TXT7874207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00650548OtherRAILROAD MEDICARE
KYP00465602OtherRAILROAD MEDICARE
IN200904770Medicaid
KY50017963OtherPASSPORT
KY7100014880Medicaid
000000579346OtherBLUE CROSS BLUE SHIELD
KY50017963OtherPASSPORT
KY7100014880Medicaid