Provider Demographics
NPI:1508438458
Name:TIPPINS, CRISTINA (DPT)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:TIPPINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 MAPLESHADE LN APT 1093
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6007
Mailing Address - Country:US
Mailing Address - Phone:678-492-1348
Mailing Address - Fax:
Practice Address - Street 1:1601 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3520
Practice Address - Country:US
Practice Address - Phone:678-492-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3127649225100000X
TX1350160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT152-1149-4806OtherDRIVERS LICENSE