Provider Demographics
NPI:1063480770
Name:KERSHNER, DANIEL J (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:KERSHNER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16806 BASEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-494-5795
Mailing Address - Fax:
Practice Address - Street 1:9000 SOUTHWEST FWY
Practice Address - Street 2:SUITE 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1526
Practice Address - Country:US
Practice Address - Phone:713-779-5800
Practice Address - Fax:713-779-5885
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1125722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist