Provider Demographics
NPI:1699895763
Name:WATSON, KRISTIN MARIE (PT)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MARIE
Last Name:WATSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17320 RED OAK DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2633
Mailing Address - Country:US
Mailing Address - Phone:281-587-2640
Mailing Address - Fax:281-586-0543
Practice Address - Street 1:17320 RED OAK DR
Practice Address - Street 2:SUITE 106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2633
Practice Address - Country:US
Practice Address - Phone:281-587-2640
Practice Address - Fax:281-586-0543
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152910174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist