Provider Demographics
NPI:1801872361
Name:CHRISTIANSEN, DON E (DO)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:E
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:222 S CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4529
Mailing Address - Country:US
Mailing Address - Phone:972-298-6174
Mailing Address - Fax:972-709-1570
Practice Address - Street 1:222 S CEDAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4529
Practice Address - Country:US
Practice Address - Phone:972-298-6174
Practice Address - Fax:972-709-1570
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00991697-01Medicaid
TX00K627Medicare ID - Type Unspecified
TX00991697-01Medicaid