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General NPI Number Information
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NPI Number | 1588633390
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN KOCHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 1310 PALUXY RD
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City | GRANBURY
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State | TX
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Zip | 76048-5655
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Country | US
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Telephone | 817-573-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 215 LOMA BLANCA LN
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City | CRESSON
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State | TX
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Zip | 76035-4613
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Country | US
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Telephone | 817-964-9711
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01054146A
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License Number State | IN
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