Charles Nathaniel Fontenette Jr., PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2029932 Issued in TX

Practice address

11001 Crescent Moon Dr
Houston, TX 77064-4024

Phone

(281) 477-8877

NPI assigned

Oct 15, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1558024638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 JUNELL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770886300",
            "telephone_number": "832-545-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 CRESCENT MOON DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770644024",
            "telephone_number": "281-477-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENETTE",
        "first_name": "CHARLES",
        "middle_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "2029932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefani Fontana, M.D.
• Montserrat Fontanals Caravaca, MD
• Charles Eugene Fontanier, DO
• Hazel Ocera Fontanilla, R.N.
• Cristiane Sa Roriz Fonteles, DDS, MS, PHD
• Deborah Ellen Fontenette, O.D.
• Rashunda Jade Fontenot-Collins, NP-C
• Alicia Fontenot
• Benjamin P Fontenot, CRNA
• Cameron Clarke Fontenot, CNP

• Physical Medicine & Rehabilitation Physician in Houston, TX
• Providers in Houston, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.