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General NPI Number Information
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NPI Number | 1952242828
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Entity Type | Individual
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Provider Name | KALIEA GREEN
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Gender | Female
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 205 E HACKBERRY ST
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City | PEARSALL
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State | TX
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Zip | 78061-4415
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Country | US
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Telephone | 830-334-4152
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Fax |
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Provider Business Mailing Address
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Address Line | 702 CEDAR KYS
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City | SAN ANTONIO
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State | TX
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Zip | 78245-5193
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Country | US
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Telephone |
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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 | 1379369
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License Number State | TX
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