Healthcare Provider Details

I. General information

NPI: 1710443023
Provider Name (Legal Business Name): KIRSTEN ANNELLE TRAPP DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S ALMA DR STE 110
ALLEN TX
75013-3810
US

IV. Provider business mailing address

820 S ALMA DR STE 110
ALLEN TX
75013-3810
US

V. Phone/Fax

Practice location:
  • Phone: 214-383-0623
  • Fax: 800-213-4413
Mailing address:
  • Phone: 214-383-0623
  • Fax: 800-213-4413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1315587
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: