MEDICARE: CHRISTOPHER E DOCKINS

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
1	101YP2500X	Professional Counselor	63308	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1215121181	OTHER	TX	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1346562287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER E DOCKINS

Provider Business Mailing Address
First Line	:	6021 MORRISS RD STE 113
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-3764
Country	:	US
Telephone Number	:	214-641-6697
Fax Number	:	972-874-0523

Provider Business Practice Location Address
First Line	:	6021 MORRISS RD STE 113
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-3764
Country	:	US
Telephone Number	:	214-641-6697
Fax Number	:	972-874-0523

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	MR. CHRISTOPHER E. DOCKINS
Credential	:	LPC
Telephone Number	:	214-641-6697

Provider Enumeration Date	:	02/19/2010
Last Update Date	:	06/09/2010

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