Provider Demographics
NPI:1538196548
Name:KOEBBE, CHRISTOPHER J (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:KOEBBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7703 FLOYD CURL DR # MC7977
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-358-8555
Mailing Address - Fax:210-358-8576
Practice Address - Street 1:4502 MEDICAL DR FL 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-358-8555
Practice Address - Fax:210-358-8576
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2018-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM9422207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200297402OtherCSHCN
TX200297404OtherCSHCN
TX8AL632OtherBCBS
TX200297403Medicaid
TX200297401Medicaid