Provider Demographics
NPI:1780709493
Name:INCE, CHRISTOPHER WERNER (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WERNER
Last Name:INCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 12TH AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3926
Mailing Address - Country:US
Mailing Address - Phone:817-328-1010
Mailing Address - Fax:817-472-2188
Practice Address - Street 1:1001 12TH AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3926
Practice Address - Country:US
Practice Address - Phone:817-328-1010
Practice Address - Fax:817-472-2188
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-115696207LP2900X
TXMDN4491207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine