Provider Demographics
NPI:1801149224
Name:MCLARTY, CHRISTIE DUCOTE (DC)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:DUCOTE
Last Name:MCLARTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WILLIAM D FITCH PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-7447
Mailing Address - Country:US
Mailing Address - Phone:979-696-1996
Mailing Address - Fax:
Practice Address - Street 1:750 WILLIAM D FITCH PKWY STE 240
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-7447
Practice Address - Country:US
Practice Address - Phone:979-696-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor