Provider Demographics
NPI:1871906693
Name:COMPTON, CHRISTIN AUTUMN (PTA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:AUTUMN
Last Name:COMPTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:CHRISTIN
Other - Middle Name:AUTUMN
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:219 BRIGHT TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5283
Mailing Address - Country:US
Mailing Address - Phone:318-469-2707
Mailing Address - Fax:
Practice Address - Street 1:6800 PARK TEN BLVD # 246
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4211
Practice Address - Country:US
Practice Address - Phone:210-377-3742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2101048225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant