Provider Demographics
NPI:1366529711
Name:CHRISTOPHER J HASSELTINE MD PA
Entity type:Organization
Organization Name:CHRISTOPHER J HASSELTINE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:HASSELTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-573-0041
Mailing Address - Street 1:5303 TRINITY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-6165
Mailing Address - Country:US
Mailing Address - Phone:325-573-3757
Mailing Address - Fax:325-573-3917
Practice Address - Street 1:5303 TRINITY BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-6165
Practice Address - Country:US
Practice Address - Phone:325-573-3757
Practice Address - Fax:325-573-3917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG52272Medicare UPIN