MEDICARE: CHRISTINA NELSON

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	235Z00000X	Speech-Language Pathologist	109908	TX

General Provider Information

NPI Number	:	1528479037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA NELSON

Provider Business Mailing Address
First Line	:	3633 WEST DALLAS
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019
Country	:	US
Telephone Number	:	713-523-3633
Fax Number	:	713-523-8399

Provider Business Practice Location Address
First Line	:	3633 WEST DALLAS
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019
Country	:	US
Telephone Number	:	713-523-3633
Fax Number	:	713-523-8399

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

Provider Enumeration Date	:	05/19/2014
Last Update Date	:	05/19/2014

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Directions to “ CHRISTINA NELSON ” Practice Location

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