Provider Demographics
NPI:1407561319
Name:LUGO, CHRISTIAN
Entity Type:Individual
Prefix:MS
First Name:CHRISTIAN
Middle Name:
Last Name:LUGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11355 RICHMOND AVE APT 419
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-7638
Mailing Address - Country:US
Mailing Address - Phone:718-664-5143
Mailing Address - Fax:
Practice Address - Street 1:11355 RICHMOND AVE APT 419
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-7638
Practice Address - Country:US
Practice Address - Phone:718-664-5143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician