1891112736 NPI number — DR. CHRISTINA VICTORIA WARNER MD

Table of content: DR. CHRISTINA VICTORIA WARNER MD (NPI 1891112736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891112736 NPI number — DR. CHRISTINA VICTORIA WARNER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARNER
Provider First Name:
CHRISTINA
Provider Middle Name:
VICTORIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891112736
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 W DALLAS ST APT 338
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77019-4091
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-888-9454
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4301 GARTH ROAD
Provider Second Line Business Practice Location Address:
PLAZA 2, SUITE 303
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77521-3158
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
462-921-4703
Provider Business Practice Location Address Fax Number:
343-292-1471
Provider Enumeration Date:
03/27/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208C00000X , with the licence number: T9278 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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