Provider Demographics
NPI:1538382338
Name:KENDALL, DEBORAH DIANE (PT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DIANE
Last Name:KENDALL
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 1:2125 AUGUSTA DR APT 24
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3713
Mailing Address - Country:US
Mailing Address - Phone:832-772-9623
Mailing Address - Fax:
Practice Address - Street 1:2125 AUGUSTA DR APT 24
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3713
Practice Address - Country:US
Practice Address - Phone:832-772-9623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1104040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist