Provider Demographics
NPI:1255182150
Name:POWELL, CHRISTOPHER CRAIG
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CRAIG
Last Name:POWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 EL PASEO ST APT 32208
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3064
Mailing Address - Country:US
Mailing Address - Phone:214-284-3643
Mailing Address - Fax:
Practice Address - Street 1:1941 EAST RD STE 3236
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2744
Practice Address - Fax:713-486-2553
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program