Healthcare Provider Details

I. General information

NPI: 1356851513
Provider Name (Legal Business Name): KRISTEN ELISE HUNSUCK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 E COMMON ST STE 400
NEW BRAUNFELS TX
78130-6079
US

IV. Provider business mailing address

6200 E CANYON RIM RD STE 113-E
ANAHEIM CA
92807-4317
US

V. Phone/Fax

Practice location:
  • Phone: 830-620-4922
  • Fax: 830-625-1194
Mailing address:
  • Phone: 714-974-0330
  • Fax: 714-279-6771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1316383
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number293681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: