Healthcare Provider Details

I. General information

NPI: 1982201844
Provider Name (Legal Business Name): 1ST CLASSEN PHYSICAL THERAPY , PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 PARK GROVE DR
KATY TX
77450-1571
US

IV. Provider business mailing address

450 PARK GROVE DR
KATY TX
77450-1571
US

V. Phone/Fax

Practice location:
  • Phone: 281-435-5732
  • Fax: 281-829-4567
Mailing address:
  • Phone: 281-435-5732
  • Fax: 281-829-4567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN CLASSEN
Title or Position: OWNER
Credential: DPT
Phone: 281-435-5732