Provider Demographics
NPI:1477903938
Name:KRESS, KADIE PATRICIA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KADIE
Middle Name:PATRICIA
Last Name:KRESS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4718 CYPRESS MILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-5515
Mailing Address - Country:US
Mailing Address - Phone:210-685-0630
Mailing Address - Fax:
Practice Address - Street 1:4718 CYPRESS MILL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247
Practice Address - Country:US
Practice Address - Phone:210-685-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61494225100000X
WY1820225100000X
TX1261308225100000X
COPTL.0013788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist