Provider Demographics
NPI:1831108182
Name:WOOD, CHRISTINE CEDERGREEN
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:CEDERGREEN
Last Name:WOOD
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 1:3234 BANDERA RUN LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2776
Mailing Address - Country:US
Mailing Address - Phone:541-499-7534
Mailing Address - Fax:
Practice Address - Street 1:9432 KATY FWY STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055
Practice Address - Country:US
Practice Address - Phone:815-585-4372
Practice Address - Fax:281-558-5443
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59248292401225100000X
TX1256719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT59248292401OtherUTAH STATE LICENSE
TX1256719OtherTEXAS STATE LICENSE