Healthcare Provider Details

I. General information

NPI: 1689195810
Provider Name (Legal Business Name): CHRISTOPHER DANIELE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 BERTNER AVE STE O-520
HOUSTON TX
77030-2604
US

IV. Provider business mailing address

3601 4TH STREET TTUHSC DEPARTMENT OF ANESTHESIOLOGY
LUBBOCK TX
79430-0001
US

V. Phone/Fax

Practice location:
  • Phone: 832-355-2666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number036.164731
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberV2051
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: