Provider Demographics
NPI:1194857045
Name:LOVING, KIMBERLYN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KIMBERLYN
Middle Name:
Last Name:LOVING
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23110 FORD RD
Mailing Address - Street 2:STE. A
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365
Mailing Address - Country:US
Mailing Address - Phone:281-354-3383
Mailing Address - Fax:281-354-6750
Practice Address - Street 1:23110 FORD RD.
Practice Address - Street 2:STE. A
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365
Practice Address - Country:US
Practice Address - Phone:281-354-3383
Practice Address - Fax:281-354-6750
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1138220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist