Provider Demographics
NPI:1396321196
Name:VANDREUMEL, CHRISTOPHER RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:VANDREUMEL
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 1:8316 SUFFOLK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-5914
Mailing Address - Country:US
Mailing Address - Phone:225-276-1081
Mailing Address - Fax:
Practice Address - Street 1:6431 FANNIN STREET
Practice Address - Street 2:STE MSB 1.255E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-325-7222
Practice Address - Fax:713-500-6829
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2556720Medicaid