Provider Demographics
NPI:1780692947
Name:HARPER, KIRSTEN (MPT)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12952 BANDERA RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4689
Mailing Address - Country:US
Mailing Address - Phone:210-372-9600
Mailing Address - Fax:210-372-9923
Practice Address - Street 1:12952 BANDERA RD
Practice Address - Street 2:SUITE 107
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4689
Practice Address - Country:US
Practice Address - Phone:210-372-9600
Practice Address - Fax:210-372-9923
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210665001Medicaid
TX8T4198OtherBLUE CROSS/SHIELD
TX210665001Medicaid