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NPI Code Detail

MEDICARE: MR. CHRISTOPHER CHARLES RIDDICK LPC

MEDICARE: MR. CHRISTOPHER CHARLES RIDDICK LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor14255TX

General Provider Information

NPI Number : 1326021205
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER CHARLES RIDDICK LPC
Provider Business Mailing Address
First Line : 580 S DENTON TAP RD
Second Line : SUITE 270
City : COPPELL
State : TX
Zip : 75019-4098
Country : US
Telephone Number : 972-393-1596
Fax Number : 972-304-0400
Provider Business Practice Location Address
First Line : 580 S DENTON TAP RD
Second Line : SUITE 270
City : COPPELL
State : TX
Zip : 75019-4098
Country : US
Telephone Number : 972-393-1596
Fax Number : 972-304-0400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/08/2007

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Directions to “ MR. CHRISTOPHER CHARLES RIDDICK LPC” Practice Location

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