Provider Demographics
NPI:1235850231
Name:BAUGHMAN, KELSEY (PTA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 LA BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8934
Mailing Address - Country:US
Mailing Address - Phone:713-652-4052
Mailing Address - Fax:713-652-5868
Practice Address - Street 1:2202 LA BRANCH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8934
Practice Address - Country:US
Practice Address - Phone:713-652-4052
Practice Address - Fax:713-652-5868
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2159955225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant