Individual
CHRISTIE SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12360 RICHMOND AVE APT 821, HOUSTON, TX 77082-2450
(713) 518-5575
Mailing address
12360 RICHMOND AVE APT 821, HOUSTON, TX 77082-2450
(713) 518-5575
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N/A
—
TX
Enumeration date
03/16/2017
Last updated
03/16/2017
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