Organization
OCCUPATIONAL AND REHABILITATION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA BARRETT CREDENTIALER (COORDINATOR)
(817) 573-9800
Entity
Organization
Contact information
Practice address
2040 NORTH LOOP W STE 330, HOUSTON, TX 77018-8114
(713) 884-8180
(713) 583-1997
Mailing address
2040 NORTH LOOP W STE 330, HOUSTON, TX 77018-8114
(713) 884-8180
(713) 583-1997
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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