Provider Demographics
NPI:1023369519
Name:HATTEN, CARLA SUE (CNIM)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:SUE
Last Name:HATTEN
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10055 BELKNAP RD
Mailing Address - Street 2:#114
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-1102
Mailing Address - Country:US
Mailing Address - Phone:281-495-5966
Mailing Address - Fax:281-495-5799
Practice Address - Street 1:10055 BELKNAP RD
Practice Address - Street 2:#114
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-1102
Practice Address - Country:US
Practice Address - Phone:281-495-5966
Practice Address - Fax:281-495-5799
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX44OtherCNIM