Provider Demographics
NPI:1750673554
Name:WALKER, CHRISTIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 CLINIC DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2117
Mailing Address - Country:US
Mailing Address - Phone:903-920-0900
Mailing Address - Fax:903-920-0894
Practice Address - Street 1:1212 CLINIC DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2117
Practice Address - Country:US
Practice Address - Phone:903-920-0900
Practice Address - Fax:903-920-0894
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60541358207V00000X
TXT5689207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1750673554Medicaid
WA8939730Medicare PIN