Provider Demographics
NPI:1932590551
Name:DIETER, CHRIS E (CO, LO)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:E
Last Name:DIETER
Suffix:
Gender:M
Credentials:CO, LO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 WEST LOOP S
Mailing Address - Street 2:STE 1200
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2115
Mailing Address - Country:US
Mailing Address - Phone:713-660-8801
Mailing Address - Fax:713-660-8809
Practice Address - Street 1:5420 WEST LOOP S
Practice Address - Street 2:STE 1200
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2115
Practice Address - Country:US
Practice Address - Phone:713-660-8801
Practice Address - Fax:713-660-8809
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX463222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist