MEDICARE: CLAUDETTE MICHELLE PONTON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	79805	ID
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	301935	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	61539371	WA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1018599	TX
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	78526	NM

General Provider Information

NPI Number	:	1225803125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDETTE MICHELLE PONTON NP

Provider Business Mailing Address
First Line	:	8145 HIGHWAY 6 S STE 112
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5739
Country	:	US
Telephone Number	:	832-535-2363
Fax Number	:	855-326-0909

Provider Business Practice Location Address
First Line	:	8145 HIGHWAY 6 S STE 112
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5739
Country	:	US
Telephone Number	:	833-535-2363
Fax Number	:	855-326-0909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2023
Last Update Date	:	01/12/2026

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