Provider Demographics
NPI:1932316460
Name:STOLLE, CHRIS ELLIOTT (PTA)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:ELLIOTT
Last Name:STOLLE
Suffix:
Gender:M
Credentials:PTA
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 609
Mailing Address - Street 2:818 JOHN ALBERT DR.
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435-0609
Mailing Address - Country:US
Mailing Address - Phone:979-335-4787
Mailing Address - Fax:
Practice Address - Street 1:14857 SOUTHWEST FWY
Practice Address - Street 2:SUITE C-303
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:281-242-8900
Practice Address - Fax:281-242-0355
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2029098225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant