Provider Demographics
NPI:1134480908
Name:STALLARD, CHRISTOPHER A (FNP-C, AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:A
Last Name:STALLARD
Suffix:
Gender:M
Credentials:FNP-C, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 N BRYANT BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-2861
Mailing Address - Country:US
Mailing Address - Phone:325-747-1511
Mailing Address - Fax:
Practice Address - Street 1:2626 N BRYANT BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-2861
Practice Address - Country:US
Practice Address - Phone:325-747-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121260363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily