Provider Demographics
NPI:1790117158
Name:COLLINS, CHRISTOPHER LEE ROY (PT, DPT, CERT DN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE ROY
Last Name:COLLINS
Suffix:
Gender:M
Credentials:PT, DPT, CERT DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 ROCKY POINT TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-2448
Mailing Address - Country:US
Mailing Address - Phone:682-289-9840
Mailing Address - Fax:682-651-0707
Practice Address - Street 1:6060 ROCKY POINT TRL STE 100
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2448
Practice Address - Country:US
Practice Address - Phone:682-289-9840
Practice Address - Fax:682-651-0707
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1233741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist