Provider Demographics
NPI:1518635986
Name:MEDINA ARAIZA, CHRISTOPER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPER
Middle Name:
Last Name:MEDINA ARAIZA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10050 SPARKS DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75704-3933
Mailing Address - Country:US
Mailing Address - Phone:903-780-4597
Mailing Address - Fax:
Practice Address - Street 1:703 STATE HWY 31 W E
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758
Practice Address - Country:US
Practice Address - Phone:903-849-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist