Provider Demographics
NPI:1689862120
Name:TALABOCK, CHRISTOPHER P (RN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:P
Last Name:TALABOCK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 5TH AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7300
Mailing Address - Country:US
Mailing Address - Phone:817-878-5300
Mailing Address - Fax:817-878-5307
Practice Address - Street 1:800 5TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7300
Practice Address - Country:US
Practice Address - Phone:817-878-5300
Practice Address - Fax:817-878-5307
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX746009163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical