Provider Demographics
NPI:1356427470
Name:SELLERS, CHRISTOPHER LEE (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:SELLERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 N. MO PAC EXPRESSWAY
Mailing Address - Street 2:BLD 3 STE 3101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-491-7772
Mailing Address - Fax:512-339-6806
Practice Address - Street 1:6500 N. MO PAC EXPRESSWAY
Practice Address - Street 2:BLD 3 STE 3101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-491-7772
Practice Address - Fax:512-339-6806
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80380UOtherGROUP
TXU92470Medicare UPIN
TX80380UOtherGROUP