Basic Information
Provider Information
NPI: 1356629000
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FELLER
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3663 BRIARPARK DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770425205
CountryCode: US
TelephoneNumber: 7132683630
FaxNumber: 6238691717
Practice Location
Address1: 4800 W BELLFORT ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770353400
CountryCode: US
TelephoneNumber: 7137210052
FaxNumber: 7135518327
Other Information
ProviderEnumerationDate: 07/29/2011
LastUpdateDate: 07/29/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X50272TXY Pharmacy Service ProvidersPharmacist 

No ID Information.


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