Provider Demographics
NPI:1912424284
Name:CORDERO, CHRISTOPHER GEORGE
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:CORDERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 CHICK PEA LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1049
Mailing Address - Country:US
Mailing Address - Phone:512-250-8800
Mailing Address - Fax:
Practice Address - Street 1:14028 N HWY 183 STE 120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-5996
Practice Address - Country:US
Practice Address - Phone:512-250-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-27
Last Update Date:2017-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist