Provider Demographics
NPI:1114418613
Name:MCCALEB, KAITLIN REID (DPT)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:REID
Last Name:MCCALEB
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 1:5252 WESTCHESTER ST BLDG 255
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4108
Mailing Address - Country:US
Mailing Address - Phone:713-360-0300
Mailing Address - Fax:713-661-0410
Practice Address - Street 1:5252 WESTCHESTER ST BLDG 255
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4108
Practice Address - Country:US
Practice Address - Phone:713-360-0300
Practice Address - Fax:713-661-0410
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1304783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist