MEDICARE: CHRISTENE INGRAM

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	363LF0000X	Family Nurse Practitioner	AP126744	TX

General Provider Information

NPI Number	:	1700281458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTENE INGRAM

Provider Business Mailing Address
First Line	:	8221 GULF FWY
Second Line	:	#400
City	:	HOUSTON
State	:	TX
Zip	:	77017-4538
Country	:	US
Telephone Number	:	713-847-9400
Fax Number	:	713-847-9405

Provider Business Practice Location Address
First Line	:	8221 GULF FWY
Second Line	:	#400
City	:	HOUSTON
State	:	TX
Zip	:	77017-4538
Country	:	US
Telephone Number	:	713-847-9400
Fax Number	:	713-847-9405

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

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	02/24/2022

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Directions to “ CHRISTENE INGRAM ” Practice Location

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