MEDICARE: MR. CHRISTOPHER ADAM VASQUEZ PTA

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	225200000X	Physical Therapy Assistant	2140770	TX

General Provider Information

NPI Number	:	1871385864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER ADAM VASQUEZ PTA

Provider Business Mailing Address
First Line	:	2804 L DON DODSON DR APT 1217
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-7952
Country	:	US
Telephone Number	:	469-432-9806
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 AIRPORT FWY STE 370
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-6624
Country	:	US
Telephone Number	:	682-802-7964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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