Healthcare Provider Details

I. General information

NPI: 1942479993
Provider Name (Legal Business Name): CHRISTINE K. VALENTINE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 RANCH ROAD 3237 DEER CREEK OF WIMBERLEY
WIMBERLEY TX
78676
US

IV. Provider business mailing address

555 RANCH ROAD 3237 DEER CREEK OF WIMBERLEY
WIMBERLEY TX
78676
US

V. Phone/Fax

Practice location:
  • Phone: 512-847-5540
  • Fax: 512-847-0419
Mailing address:
  • Phone: 512-847-5540
  • Fax: 512-847-0419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1175275
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: