Provider Demographics
NPI:1639473127
Name:CRIST, THOMAS (SA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CRIST
Suffix:
Gender:M
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10039 BISSONNET ST STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7852
Mailing Address - Country:US
Mailing Address - Phone:713-779-9800
Mailing Address - Fax:
Practice Address - Street 1:10039 BISSONNET ST STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7852
Practice Address - Country:US
Practice Address - Phone:713-779-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist