Provider Demographics
NPI:1134374424
Name:WATSON, CHRISTOPHER BRUCE (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRUCE
Last Name:WATSON
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 STONE OAK LOOP
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3510
Mailing Address - Country:US
Mailing Address - Phone:210-268-0129
Mailing Address - Fax:210-497-8333
Practice Address - Street 1:18707 HARDY OAK BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4890
Practice Address - Country:US
Practice Address - Phone:844-789-7246
Practice Address - Fax:888-880-9323
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06007363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453646424OtherEIN
TX742824455OtherEIN