Provider Demographics
NPI:1932499423
Name:LE-SHORT, CHRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:LE-SHORT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WILLOWEND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7631
Mailing Address - Country:US
Mailing Address - Phone:504-669-3480
Mailing Address - Fax:
Practice Address - Street 1:944 MERION SQUARE RD
Practice Address - Street 2:
Practice Address - City:GLADWYNE
Practice Address - State:PA
Practice Address - Zip Code:19035-1510
Practice Address - Country:US
Practice Address - Phone:617-299-9960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11651800207LP2900X
NY319616207LP2900X
TXQ4173207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine