Individual
KRISTINA PORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
33518 HALEY RD # 1, WALLER, TX 77484-5110
(888) 344-2947
(281) 622-4381
Mailing address
33518 HALEY RD # 1, WALLER, TX 77484-5110
(888) 344-2947
(281) 622-4381
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199
R EP T
—
01
—
292
R EEG T
—
01
—
450
CNIM
—
Enumeration date
10/20/2014
Last updated
10/20/2014
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