Provider Demographics
NPI:1215511472
Name:CORTINA, CALEB ELIHU
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:ELIHU
Last Name:CORTINA
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 1:25925 BUDDE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2011
Mailing Address - Country:US
Mailing Address - Phone:281-651-5120
Mailing Address - Fax:281-271-9089
Practice Address - Street 1:25925 BUDDE RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2011
Practice Address - Country:US
Practice Address - Phone:281-651-5120
Practice Address - Fax:281-271-9089
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst