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Individual

CHRISTAN DEPAUL RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
17202 KOBUK VALLEY CIR, HUMBLE, TX 77346-2951
(832) 757-6332
Mailing address
17202 KOBUK VALLEY CIR, HUMBLE, TX 77346-2951
(832) 757-6332

Taxonomy

Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
K9120
TX

Other

Enumeration date
10/09/2019
Last updated
10/09/2019
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