Provider Demographics
NPI:1740696020
Name:POKLUDA, CHRISTINE (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:POKLUDA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:9816 MEMORIAL BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4255
Practice Address - Country:US
Practice Address - Phone:281-913-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57190104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker