Provider Demographics
NPI:1962577718
Name:CHRISTIAN, CHARLES BRITTON JR (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BRITTON
Last Name:CHRISTIAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4499 MEDICAL DR STE 225
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3788
Mailing Address - Country:US
Mailing Address - Phone:210-616-0836
Mailing Address - Fax:210-616-0586
Practice Address - Street 1:4499 MEDICAL DR STE 225
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3788
Practice Address - Country:US
Practice Address - Phone:210-616-0836
Practice Address - Fax:210-616-0586
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG6066208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742334682OtherFED TAX ID
TX742334682OtherFED TAX ID
TX00G267Medicare ID - Type Unspecified