Provider Demographics
NPI:1073327011
Name:HOUSTON, CHRISTOPHER
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 DOUBLE JACK LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-8010
Mailing Address - Country:US
Mailing Address - Phone:336-972-8564
Mailing Address - Fax:
Practice Address - Street 1:2014 DOUBLE JACK LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-8010
Practice Address - Country:US
Practice Address - Phone:336-972-8564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness