Provider Demographics
NPI:1881779502
Name:EISENHAUER, CHRISTOPHER N (MD, DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:N
Last Name:EISENHAUER
Suffix:
Gender:M
Credentials:MD, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S COULTER ST
Mailing Address - Street 2:SUITE 5100
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1786
Mailing Address - Country:US
Mailing Address - Phone:806-414-9559
Mailing Address - Fax:806-351-3765
Practice Address - Street 1:1400 S COULTER ST
Practice Address - Street 2:SUITE 5100
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:806-414-9559
Practice Address - Fax:806-351-3765
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8765111N00000X
390200000X
TXQ9601207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV01810Medicare UPIN
TX611040Medicare ID - Type Unspecified