Provider Demographics
NPI:1720623192
Name:CHRISTLINE HEALTHCARE INC.
Entity Type:Organization
Organization Name:CHRISTLINE HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:UKOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:713-909-6764
Mailing Address - Street 1:9711 S MASON RD # 125-267
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7167
Mailing Address - Country:US
Mailing Address - Phone:713-909-6764
Mailing Address - Fax:248-458-4571
Practice Address - Street 1:9711 S MASON RD # 125-267
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7167
Practice Address - Country:US
Practice Address - Phone:713-909-6764
Practice Address - Fax:248-458-4571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-09
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1144417106OtherOWNER NPI