Provider Demographics
NPI:1689861213
Name:BISCHOFF, KRISTOPHER EDWARD (PTA)
Entity Type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:EDWARD
Last Name:BISCHOFF
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 SEABURY DR
Mailing Address - Street 2:Q224
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-3100
Mailing Address - Country:US
Mailing Address - Phone:940-867-6540
Mailing Address - Fax:
Practice Address - Street 1:4200 SEABURY DR
Practice Address - Street 2:Q224
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-3100
Practice Address - Country:US
Practice Address - Phone:940-867-6540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2029114225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant