Provider Demographics
NPI:1871648451
Name:CHRISTMAN, GARY RICHARD (DDS)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:RICHARD
Last Name:CHRISTMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5438
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-5438
Mailing Address - Country:US
Mailing Address - Phone:281-360-8118
Mailing Address - Fax:
Practice Address - Street 1:3872 FM 350 S
Practice Address - Street 2:POLUNSKY UNIT / DENTAL DEPARTMENT
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8580
Practice Address - Country:US
Practice Address - Phone:936-967-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9038122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist