MEDICARE: CHRISTINA LORRAINE CONTRERAS P.A.-C

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	363A00000X	Physician Assistant		TX
2	363AM0700X	Medical Physician Assistant	2186	WI
3	363A00000X	Physician Assistant	PA05948	TX

General Provider Information

NPI Number	:	1992997787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA LORRAINE CONTRERAS P.A.-C

Provider Business Mailing Address
First Line	:	950 THREADNEEDLE
Second Line	:	SUITE 160
City	:	HOUSTON
State	:	TX
Zip	:	77079-2948
Country	:	US
Telephone Number	:	832-379-8200
Fax Number	:	832-379-8201

Provider Business Practice Location Address
First Line	:	950 THREADNEEDLE
Second Line	:	SUITE 160
City	:	HOUSTON
State	:	TX
Zip	:	77079-2948
Country	:	US
Telephone Number	:	832-379-8200
Fax Number	:	832-379-8201

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

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	11/30/2011

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Directions to “ CHRISTINA LORRAINE CONTRERAS P.A.-C” Practice Location

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