Provider Demographics
NPI:1982626503
Name:WILSON, CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 GRAHAM DR STE D
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3335
Mailing Address - Country:US
Mailing Address - Phone:281-351-7127
Mailing Address - Fax:281-255-9140
Practice Address - Street 1:909 GRAHAM DR STE D
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3335
Practice Address - Country:US
Practice Address - Phone:281-351-7127
Practice Address - Fax:281-255-9140
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily