Provider Demographics
NPI:1548656341
Name:KENDALL, GRANT M (DPT)
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:M
Last Name:KENDALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18626 HARDY OAK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4228
Mailing Address - Country:US
Mailing Address - Phone:210-495-9047
Mailing Address - Fax:210-293-3126
Practice Address - Street 1:9150 HUEBNER RD STE 290
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1598
Practice Address - Country:US
Practice Address - Phone:210-614-6432
Practice Address - Fax:210-615-7743
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9248990-2401225100000X
TX1340142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist