Provider Demographics
NPI:1447552609
Name:MCSPADDEN, CHRISTOPHER KEITH (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KEITH
Last Name:MCSPADDEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MEDICAL PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2529
Mailing Address - Country:US
Mailing Address - Phone:512-379-3660
Mailing Address - Fax:512-379-3661
Practice Address - Street 1:1301 MEDICAL PKWY STE 140
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2529
Practice Address - Country:US
Practice Address - Phone:512-379-3660
Practice Address - Fax:512-379-3661
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1990213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302369902Medicaid
TX12361510OtherCAQH
TX7170150001Medicare PIN