1265472674 NPI number — CHRISTENE THANH TEAGUE PT, MSPT

Table of content: AILEN LUNA RODRIGUEZ (NPI 1568289577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265472674 NPI number — CHRISTENE THANH TEAGUE PT, MSPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TEAGUE
Provider First Name:
CHRISTENE
Provider Middle Name:
THANH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, MSPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TRAN
Provider Other First Name:
CHRISTENE
Provider Other Middle Name:
T
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265472674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
203 NARROWS PKWY STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-8649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-824-8850
Provider Business Mailing Address Fax Number:
205-824-8853

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1310 ALFORD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOOVER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35226-3199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-824-8850
Provider Business Practice Location Address Fax Number:
205-824-8853
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PTH6578 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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