MEDICARE: DR. KRISTINA CLEVINGER PH.D.

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	103T00000X	Psychologist	38659	TX

General Provider Information

NPI Number	:	1598427023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINA CLEVINGER PH.D.

Provider Business Mailing Address
First Line	:	17625 EL CAMINO REAL STE 225F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3052
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17625 EL CAMINO REAL STE 225F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3052
Country	:	US
Telephone Number	:	832-225-8599
Fax Number	:

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

Provider Enumeration Date	:	10/12/2021
Last Update Date	:	03/16/2026

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