Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1179380 | TX |
NPI | 1598245235 |
---|---|
Provider Name | Kristel Kay Louis |
First Address | Austin, TX 78759-7268 |
Second Address | Austin, TX 78759-7268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2018 |
Last Update Date | 21/08/2018 |