Individual
MICHAEL RAY CHRISTOPHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1306 S VINE AVE, TYLER, TX 75701-2822
(903) 520-3905
(903) 535-9304
Mailing address
1306 S VINE, TYLER, TX 75701
(903) 520-3905
(903) 535-9304
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1224803
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1224803
LIFE AND HEALTH
TX
05
—
1224803
—
TX
Enumeration date
10/02/2013
Last updated
10/02/2013
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