Provider Demographics
NPI:1487143566
Name:FRU-NCHE, CHRISTIAN C
Entity type:Individual
Prefix:
First Name:CHRISTIAN C
Middle Name:
Last Name:FRU-NCHE
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 1:10634 GREYFRIARS LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-1022
Mailing Address - Country:US
Mailing Address - Phone:336-493-3886
Mailing Address - Fax:
Practice Address - Street 1:10634 GREYFRIARS LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-1022
Practice Address - Country:US
Practice Address - Phone:336-493-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX907815163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse