Provider Demographics
NPI:1275365488
Name:ECK, CHRISTOPHER JOSE (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSE
Last Name:ECK
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-4821
Mailing Address - Country:US
Mailing Address - Phone:702-339-1747
Mailing Address - Fax:
Practice Address - Street 1:4531 MONTANA AVE STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4704
Practice Address - Country:US
Practice Address - Phone:702-339-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT123496225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist