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General NPI Number Information
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NPI Number | 1740763721
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Entity Type | Individual
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Provider Name | EMILY CHRISTOPHERSON SHUSHTARI
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Gender | Female
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 1619 SCENIC RIDGE DR
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City | HOUSTON
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State | TX
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Zip | 77043-3408
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Country | US
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Telephone | 713-859-1850
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 SCENIC RIDGE DR
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City | HOUSTON
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State | TX
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Zip | 77043-3408
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Country | US
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Telephone | 713-859-1850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP135604
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License Number State | TX
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