Provider Demographics
NPI:1841309465
Name:ALLISON, CHRISTINE P (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:P
Last Name:ALLISON
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11807 SOUTH FWY STE 360
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7045
Mailing Address - Country:US
Mailing Address - Phone:817-551-0445
Mailing Address - Fax:817-551-0629
Practice Address - Street 1:11807 SOUTH FWY STE 360
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7045
Practice Address - Country:US
Practice Address - Phone:817-551-0445
Practice Address - Fax:817-551-0629
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004648363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9110PFOtherREGENCE PROVIDER #
P00240195OtherRAILROAD MEDICARE
WA0193890OtherLABOR & INDUSTRIES PROV #
WA0193890OtherLABOR & INDUSTRIES PROV #
P74989Medicare UPIN
G8852386Medicare PIN