Provider Demographics
NPI:1295321354
Name:CHRISTMAS, WILHELMINA
Entity type:Individual
Prefix:
First Name:WILHELMINA
Middle Name:
Last Name:CHRISTMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10006 GLEN CANYON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4610
Mailing Address - Country:US
Mailing Address - Phone:214-434-8963
Mailing Address - Fax:
Practice Address - Street 1:10006 GLEN CANYON DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4610
Practice Address - Country:US
Practice Address - Phone:214-434-8963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No174H00000XOther Service ProvidersHealth Educator