Provider Demographics
NPI:1013263946
Name:CORREA, CHRISTOPHER DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:CORREA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14502 CYPRESS MILL PLACE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7300
Mailing Address - Country:US
Mailing Address - Phone:832-743-0508
Mailing Address - Fax:832-743-0588
Practice Address - Street 1:25222 NORTHWEST FWY APT 185
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1038
Practice Address - Country:US
Practice Address - Phone:832-743-0508
Practice Address - Fax:832-743-0588
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2145213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8MT028OtherBLUE CROSS AND BLUE SHIELD
TX346947003Medicaid
TX7854240001OtherDME LICENSE NUMBER
TXP02482063OtherRAIL ROAD MEDICARE
TX2456064OtherWELLCARE ID
TX1C9075OtherMEDICARE NUMBER