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General NPI Number Information
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NPI Number | 1306286711
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Entity Type | Individual
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Provider Name | KAYCIE LEAL DPT
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Gender | Female
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Dates
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Enumeration Date | 06/29/2013
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Last Update Date | 06/29/2013
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Provider Practice Location Address
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Address Line | 3120 HIGHWAY 36 S
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City | BRENHAM
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State | TX
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Zip | 77833-7002
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Country | US
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Telephone | 979-277-9935
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Fax |
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Provider Business Mailing Address
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Address Line | 3317 RYAN RD
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City | BRENHAM
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State | TX
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Zip | 77833-7386
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Country | US
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Telephone | 619-507-2779
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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 | 1190551
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License Number State | TX
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