MEDICARE: KATHERINE CARPENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist	119020	TX
2	247200000X	Other Technician

General Provider Information

NPI Number	:	1316681927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE CARPENTER

Provider Business Mailing Address
First Line	:	825 CLEAR STREAM XING
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78753-7124
Country	:	US
Telephone Number	:	713-822-1232
Fax Number	:

Provider Business Practice Location Address
First Line	:	11979 STARCREST DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4112
Country	:	US
Telephone Number	:	512-820-8293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2022
Last Update Date	:	11/08/2024

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Directions to “ KATHERINE CARPENTER ” Practice Location

Language	Start Address	Practice Location

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