Individual
MR. CHARLES NATHANIEL FONTENETTE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
11001 CRESCENT MOON DR, HOUSTON, TX 77064-4024
(281) 477-8877
Mailing address
830 JUNELL ST, HOUSTON, TX 77088-6300
(832) 545-0977
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2029932
TX
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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