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Individual

DR. CHRISTOPHER SEAN FATTE BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8160 WALNUT HILL LN, PEROT SUITE 007, DALLAS, TX 75231-4339
(214) 345-5930
Mailing address
8160 WALNUT HILL LN, PEROT SUITE 007, DALLAS, TX 75231-4339
(214) 345-5930

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J7752
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0011EK
BCBS
TX
05
126641301
TX
05
126641305
TX
01
89191F
BCBS
TX
01
930078715
MEDICARE RAILROAD
TX
Enumeration date
12/15/2005
Last updated
02/19/2008
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