Provider Demographics
NPI:1174296792
Name:PRAK, CHRISTINA NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:NICOLE
Last Name:PRAK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 LAUREL OAK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3219
Mailing Address - Country:US
Mailing Address - Phone:281-248-1570
Mailing Address - Fax:
Practice Address - Street 1:7315 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3130
Practice Address - Country:US
Practice Address - Phone:281-812-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37633122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist