Provider Demographics
NPI:1417738188
Name:HELOU-DECOS, CHRISTOPHER R (MS, BS, AT, MT, MMP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R
Last Name:HELOU-DECOS
Suffix:
Gender:
Credentials:MS, BS, AT, MT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3625 FRANKFORD AVE APT 4108
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-1945
Mailing Address - Country:US
Mailing Address - Phone:281-771-2149
Mailing Address - Fax:240-770-0602
Practice Address - Street 1:3625 FRANKFORD AVE APT 4108
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-1945
Practice Address - Country:US
Practice Address - Phone:281-771-2149
Practice Address - Fax:240-770-0602
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL73122255A2300X
TXMT137388225700000X
TXAT98592255A2300X
FL105780225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer