Provider Demographics
NPI:1467330407
Name:WATERS, CHRISTOPHER ANDRE
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDRE
Last Name:WATERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 NW HEINZWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-4950
Mailing Address - Country:US
Mailing Address - Phone:580-647-6047
Mailing Address - Fax:
Practice Address - Street 1:2305 SW H AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8103
Practice Address - Country:US
Practice Address - Phone:580-699-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor