Provider Demographics
NPI:1033464094
Name:FINCANNON, KARA NICOLE (DPT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:NICOLE
Last Name:FINCANNON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 BISSONNET ST
Mailing Address - Street 2:340
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3120
Mailing Address - Country:US
Mailing Address - Phone:713-838-9050
Mailing Address - Fax:713-838-0926
Practice Address - Street 1:4500 BISSONNET ST
Practice Address - Street 2:340
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3120
Practice Address - Country:US
Practice Address - Phone:713-838-9050
Practice Address - Fax:713-838-0926
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1220053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist