Provider Demographics
NPI:1528030467
Name:HANSSEN, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:HANSSEN
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 1:403 W CAMPBELL RD
Mailing Address - Street 2:STE 102
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3472
Mailing Address - Country:US
Mailing Address - Phone:214-498-3640
Mailing Address - Fax:214-498-3646
Practice Address - Street 1:4716 ALLIANCE BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:469-298-3640
Practice Address - Fax:469-298-3646
Is Sole Proprietor?:No
Enumeration Date:2006-02-04
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8717207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178661802Medicaid
TX178661801Medicaid
TX8F0146Medicare PIN
TX8F0147Medicare PIN
TXI13870Medicare UPIN