Provider Demographics
NPI:1508819277
Name:IMPERIAL, CHRISTOPHER J (DD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:IMPERIAL
Suffix:
Gender:M
Credentials:DD
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Mailing Address - Street 1:1512 HOLLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840
Mailing Address - Country:US
Mailing Address - Phone:979-693-3313
Mailing Address - Fax:979-764-3097
Practice Address - Street 1:1512 HOLLEMAN DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840
Practice Address - Country:US
Practice Address - Phone:979-693-3313
Practice Address - Fax:979-764-3097
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL1893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H36566Medicare UPIN