Basic Information
| Provider Information | |||||||||
| NPI: | 1467674143 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHRISTY | ||||||||
| FirstName: | LANDON | ||||||||
| MiddleName: | CRAIG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| OtherCredential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 700688 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782700688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004046050 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1805 HINKLE DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762011768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729221915 | ||||||||
| FaxNumber: | 8663133397 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 01/12/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 33619 | CA | N | Chiropractic Providers | Chiropractor | 111N00000X | 3106 | TN | N | Chiropractic Providers | Chiropractor | 111N00000X | 1413 | LA | N | Chiropractic Providers | Chiropractor | 111N00000X | 10317 | TX | N | Chiropractic Providers | Chiropractor | 111NR0400X | 33619 | CA | N | Chiropractic Providers | Chiropractor | Rehabilitation | 111NR0400X | 3106 | TN | N | Chiropractic Providers | Chiropractor | Rehabilitation | 111NR0400X | 1413 | LA | N | Chiropractic Providers | Chiropractor | Rehabilitation | 111NS0005X | 33619 | CA | N | Chiropractic Providers | Chiropractor | Sports Physician | 111NS0005X | 3106 | TN | N | Chiropractic Providers | Chiropractor | Sports Physician | 111NS0005X | 1413 | LA | N | Chiropractic Providers | Chiropractor | Sports Physician | 111NS0005X | 10317 | TX | N | Chiropractic Providers | Chiropractor | Sports Physician | 111NR0400X | 10317 | TX | Y | Chiropractic Providers | Chiropractor | Rehabilitation |
No ID Information.