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NPI Code Detail

MEDICARE: MR. CHRISTOPHER JOHN ROBERT POPOVICH LCDC

MEDICARE:  MR. CHRISTOPHER JOHN ROBERT POPOVICH  LCDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor13325TX

General Provider Information

NPI Number : 1548726086
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER JOHN ROBERT POPOVICH LCDC
Provider Business Mailing Address
First Line : PO BOX 317
Second Line :
City : SAN MARCOS
State : TX
Zip : 78667-0317
Country : US
Telephone Number : 512-522-9811
Fax Number :
Provider Business Practice Location Address
First Line : 1205 N HWY 123 STE 305
Second Line :
City : SAN MARCOS
State : TX
Zip : 78666-7756
Country : US
Telephone Number : 512-522-9811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2019
Last Update Date : 02/20/2019

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Directions to “ MR. CHRISTOPHER JOHN ROBERT POPOVICH LCDC” Practice Location

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