Provider Demographics
NPI:1316904840
Name:EWING, CHRISTOPHER ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:EWING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2198 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-2926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 W 38TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1006
Practice Address - Country:US
Practice Address - Phone:512-324-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8333207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M6791OtherBCBS
TX8G5591OtherBCBS
TX168752710Medicaid
TX168752702Medicaid
TX8U8779OtherBCBS
TX168752703Medicaid
TX8R5601OtherBCBS
TX168752707Medicaid
TX8G5591OtherBCBS
TX8G1367Medicare PIN
TXP00271417Medicare PIN
TX8D4774Medicare PIN
TX168752707Medicaid
TX8C2362Medicare PIN
TX8R5601OtherBCBS
TX8U8779OtherBCBS
TX168752702Medicaid
TX168752703Medicaid