Healthcare Provider Details

I. General information

NPI: 1164934097
Provider Name (Legal Business Name): CHRISTINE MARIE ANDERSON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 SOUTHWEST FWY STE 200
SUGAR LAND TX
77478-3877
US

IV. Provider business mailing address

3811 AUDLEY ST APT 24305
HOUSTON TX
77098-2913
US

V. Phone/Fax

Practice location:
  • Phone: 281-494-7010
  • Fax:
Mailing address:
  • Phone: 469-463-5245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number81007
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: