Individual
CHRIS PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
12025 COPPER MINE LN, EL PASO, TX 79934-3416
(917) 344-0105
Mailing address
12025 COPPER MINE LN, EL PASO, TX 79934-3416
(917) 344-0105
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
011014
NY
227900000X
Registered Respiratory Therapist
Primary
RCP02003035
TX
227900000X
Registered Respiratory Therapist
RCP4215
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43645453
DRIVER LICENSE
TX
Enumeration date
07/22/2020
Last updated
07/22/2020
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