Provider Demographics
NPI:1093953564
Name:MESSARRA, CHRISTINE ELLEN (LM, CPM)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELLEN
Last Name:MESSARRA
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 GLENEAGLES DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5665
Mailing Address - Country:US
Mailing Address - Phone:832-385-6500
Mailing Address - Fax:281-648-2220
Practice Address - Street 1:528 GLENEAGLES DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5665
Practice Address - Country:US
Practice Address - Phone:832-385-6500
Practice Address - Fax:281-648-2220
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00006175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay