Provider Demographics
NPI:1700281458
Name:INGRAM, CHRISTENE
Entity Type:Individual
Prefix:
First Name:CHRISTENE
Middle Name:
Last Name:INGRAM
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 1:8221 GULF FWY
Mailing Address - Street 2:#400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-4538
Mailing Address - Country:US
Mailing Address - Phone:713-847-9400
Mailing Address - Fax:713-847-9405
Practice Address - Street 1:8221 GULF FWY
Practice Address - Street 2:#400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-4538
Practice Address - Country:US
Practice Address - Phone:713-847-9400
Practice Address - Fax:713-847-9405
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily