Individual
KRISTINA PETERSON MARSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1977 BUTLER BLVD, HOUSTON, TX 77030-4101
(713) 798-6141
Mailing address
2 GREENWAY PLZ, SUITE 900, HOUSTON, TX 77046-0297
(713) 798-1750
(713) 798-1144
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04360
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187010701
—
TX
01
—
8N9178
BCBS
TX
Enumeration date
07/09/2006
Last updated
08/24/2011
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