Provider Demographics
NPI:1851282875
Name:JAISON, CHRISTINE SUSAN
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SUSAN
Last Name:JAISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 IRONWOOD PASS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3795
Mailing Address - Country:US
Mailing Address - Phone:201-673-2567
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST STE 732
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5202
Practice Address - Country:US
Practice Address - Phone:713-500-7183
Practice Address - Fax:713-512-2248
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1068221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical