Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1262311 | TX |
NPI | 1023480639 |
---|---|
Provider Name | Dr. Meredith Carpenter Kennedy |
First Address | Cypress, TX 77433-6063 |
Second Address | Houston, TX 77055-7454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2015 |
Last Update Date | 21/10/2015 |