Basic Information
Provider Information
NPI: 1538454384
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HORSMAN
FirstName: CHRYSTEAN
MiddleName: JAMES
NamePrefix: MS.
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 HINSDALE DR
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760062015
CountryCode: US
TelephoneNumber: 8177959020
FaxNumber:  
Practice Location
Address1: 909 N WASHINGTON AVE
Address2:  
City: DALLAS
State: TX
PostalCode: 752461520
CountryCode: US
TelephoneNumber: 2148209365
FaxNumber: 2148209560
Other Information
ProviderEnumerationDate: 06/09/2011
LastUpdateDate: 06/09/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0019X103122TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation

No ID Information.


Home