Provider Demographics
NPI:1316007008
Name:MCCORVEY, CHRISTINE ELIZABETH (PA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:MCCORVEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 KATY FWY STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1243
Mailing Address - Country:US
Mailing Address - Phone:281-249-4325
Mailing Address - Fax:281-249-4307
Practice Address - Street 1:11720 KATY FWY STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1243
Practice Address - Country:US
Practice Address - Phone:281-249-4325
Practice Address - Fax:281-249-4307
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04775363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant