Healthcare Provider Details

I. General information

NPI: 1548369168
Provider Name (Legal Business Name): CHRISTI L GREER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTI L LAURENCE D.P.M.

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10869 CUDE CEMETERY RD
WILLIS TX
77318-6462
US

IV. Provider business mailing address

PO BOX 278
WILLIS TX
77378-0278
US

V. Phone/Fax

Practice location:
  • Phone: 346-386-3613
  • Fax:
Mailing address:
  • Phone: 346-386-3613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number1913
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number1913
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number1913
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1913
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: