Healthcare Provider Details

I. General information

NPI: 1346791175
Provider Name (Legal Business Name): KELSEY K MUSGROVE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY K SHULL DPT

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16835 DEER CREEK DR STE 120
SPRING TX
77379-5803
US

IV. Provider business mailing address

5 SNAPDRAGON CT
THE WOODLANDS TX
77381-2810
US

V. Phone/Fax

Practice location:
  • Phone: 281-379-4374
  • Fax:
Mailing address:
  • Phone: 903-241-3791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: