Provider Demographics
NPI:1982658233
Name:WALKER, CHRISTA (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-7517
Mailing Address - Country:US
Mailing Address - Phone:817-277-1165
Mailing Address - Fax:817-277-1106
Practice Address - Street 1:201 N EAST ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-7517
Practice Address - Country:US
Practice Address - Phone:817-277-1165
Practice Address - Fax:817-277-1106
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS602091223G0001X
TX253001223G0001X
MO20030112991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100337800AMedicaid