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General NPI Number Information
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NPI Number | 1114710654
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Entity Type | Individual
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Provider Name | KERSTIN TIMPONE
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 711 W BAY AREA BLVD STE 608
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City | WEBSTER
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State | TX
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Zip | 77598-4042
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Country | US
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Telephone | 281-338-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 2003 LIVE OAK RD
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City | CUERO
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State | TX
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Zip | 77954-6900
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Country | US
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Telephone | 573-808-2160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1406717
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License Number State | TX
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