Provider Demographics
NPI:1811195829
Name:CHRISTI M TUPA MD PA
Entity Type:Organization
Organization Name:CHRISTI M TUPA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFFEREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-573-7900
Mailing Address - Street 1:115 MEDICAL DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3102
Mailing Address - Country:US
Mailing Address - Phone:361-573-7900
Mailing Address - Fax:361-573-7959
Practice Address - Street 1:115 MEDICAL DR
Practice Address - Street 2:SUITE 208
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3102
Practice Address - Country:US
Practice Address - Phone:361-573-7900
Practice Address - Fax:361-573-7959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4769173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0029JVOtherBLUE CROSS