Healthcare Provider Details

I. General information

NPI: 1982998423
Provider Name (Legal Business Name): CHRIS MICHAEL MINOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 SILBER RD STE 160
HOUSTON TX
77055-2645
US

IV. Provider business mailing address

2055 SILBER RD STE 160
HOUSTON TX
77055-2645
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-1011
  • Fax:
Mailing address:
  • Phone: 713-468-0696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number3296
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: