Provider Demographics
NPI:1285102681
Name:COULON, JULIA ELIZABETH (LAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ELIZABETH
Last Name:COULON
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:ELIZABETH
Other - Last Name:GLENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2686 ELM CROSSING TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4240
Mailing Address - Country:US
Mailing Address - Phone:832-524-2624
Mailing Address - Fax:
Practice Address - Street 1:10713 W SAM HOUSTON PKWY N STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-3582
Practice Address - Country:US
Practice Address - Phone:281-529-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT77762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer