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General NPI Number Information
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NPI Number | 1588439368
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Entity Type | Individual
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Provider Name | CHRISTOPHER S FYOCK PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/02/2024
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Provider Practice Location Address
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Address Line | 215 KINGWOOD EXECUTIVE DR STE 130
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City | KINGWOOD
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State | TX
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Zip | 77339-2763
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Country | US
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Telephone | 281-348-9588
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 N 102ND ST STE 300
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City | OMAHA
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State | NE
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Zip | 68114-2122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 015216
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP031601T
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP035425T
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License Number State | TX
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