Individual
CHARLES R FONTENOT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
11301 RICHMOND AVE STE K105, HOUSTON, TX 77082-5549
(281) 293-9600
Mailing address
PO BOX 550382, HOUSTON, TX 77255-0382
(281) 546-3740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16043
TX
Other
Enumeration date
08/24/2022
Last updated
08/25/2022
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