Christopher D Lavalley
Individual provider Active NPI Home Modifications Contractor · Kingsland, TX
NPI 1730786302 · NPPES record last updated Oct 6, 2020
Key facts
- NPI
- 1730786302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Modifications Contractor 171WH0202X
- License
- TACLA00066994E (TX)
- Practice address
- 824 Anson
Kingsland, TX 78639-4234 - Phone
- (325) 388-5665
- Fax
- (325) 388-0225
- NPI assigned
- Oct 6, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TACLA00066994E | TX | MD | Home Modifications Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor |
171WH0202X | TACLA00066994E | TX | Yes |
Addresses
Primary practice location
824 Anson
Kingsland, TX 78639-4234
Mailing address
824 Anson
Kingsland, TX 78639-4234
Phone (325) 388-5665
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | o2koolrefac@gmail.com | Direct |
Other providers in Kingsland, TX
- Connie Jackson
- John J Johnson III
- Razim Kapic
- Neal Goodwin Landry
- Charles Edwin Laurence
- Alan E. Leifeste II
- Vineeth Reddy Lekkala
- Sara Lindley
- Llano County Hospital Authority
- Melinda Elstun Lockhart
All providers in Kingsland, TX · Home Modifications Contractor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.