Individual
DR. PETER AUSTIN CHRISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6435 S FM 549 STE 102, ROCKWALL, TX 75032-6221
(469) 338-5162
(949) 655-8774
Mailing address
6435 S FM 549 STE 102, HEATH, TX 75032-6221
(469) 338-5162
(949) 655-8774
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070011972
IL
2251X0800X
Orthopedic Physical Therapist
Primary
PT010325
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08220357
BCBS GRP#
IL
01
—
900068033
TAX-ID#
IL
01
—
K28891
MEDICARE #
IL
Enumeration date
03/11/2006
Last updated
11/06/2024
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