Individual
CHRISTINA NICOLE CIVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1204 MEDICAL PLAZA CT, GRANBURY, TX 76048-5653
(817) 573-5688
Mailing address
1204 MEDICAL PLAZA CT, GRANBURY, TX 76048-5653
(817) 573-5688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17636
TX
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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