Provider Demographics
NPI:1922219211
Name:CODISPOTI, CHRISTOPHER DAVID (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:CODISPOTI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 FANNIN ST STE 720
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-5205
Mailing Address - Country:US
Mailing Address - Phone:713-486-0340
Mailing Address - Fax:713-486-0350
Practice Address - Street 1:6410 FANNIN ST STE 720
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5205
Practice Address - Country:US
Practice Address - Phone:713-486-0340
Practice Address - Fax:713-486-0350
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV3267207K00000X, 207RA0201X
IL036-128987207K00000X
OH35088749207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology