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NPI Code Detail

MEDICARE: KAYLA GARRETT CLENDENINN PT, DPT

MEDICARE:   KAYLA GARRETT CLENDENINN  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1279542TX

General Provider Information

NPI Number : 1063966836
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA GARRETT CLENDENINN PT, DPT
Provider Business Mailing Address
First Line : 11450 SPACE CENTER BLVD STE 201
Second Line :
City : HOUSTON
State : TX
Zip : 77059-3642
Country : US
Telephone Number : 281-998-0901
Fax Number : 281-998-0903
Provider Business Practice Location Address
First Line : 11450 SPACE CENTER BLVD STE 201
Second Line :
City : HOUSTON
State : TX
Zip : 77059-3642
Country : US
Telephone Number : 281-998-0901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2016
Last Update Date : 05/23/2019

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Directions to “ KAYLA GARRETT CLENDENINN PT, DPT” Practice Location

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