Provider Demographics
NPI:1992997787
Name:CONTRERAS, CHRISTINA LORRAINE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LORRAINE
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:LORRAINE
Other - Last Name:DOMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:950 THREADNEEDLE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2948
Mailing Address - Country:US
Mailing Address - Phone:832-379-8200
Mailing Address - Fax:832-379-8201
Practice Address - Street 1:950 THREADNEEDLE
Practice Address - Street 2:SUITE 160
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2948
Practice Address - Country:US
Practice Address - Phone:832-379-8200
Practice Address - Fax:832-379-8201
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
WI2186363AM0700X
TXPA05948363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical